Albert Carolyne, Frei Hanspeter, Duncan Clive, Fernlund Goran
Department of Biomedical Engineering, Marquette University, Milwaukee WI, USA.
Crit Rev Biomed Eng. 2011;39(6):493-510. doi: 10.1615/critrevbiomedeng.v39.i6.20.
Failure of the femoral component of total hip arthroplasty is often accompanied by bone loss that can pose a significant challenge to the orthopaedic surgeon. Femoral impaction allografting has attractive potential for restoring bone stock in deficient femurs. However, there have been reports of problematic postoperative stem subsidence with this procedure. Subsidence is highly variable among patients, and there is disagreement over the mechanisms that cause it. This article reviews the various mechanisms that can contribute to subsidence in femoral impaction allografting. Variables such as graft density, cement penetration profile, use of synthetic graft substitutes, or other graft additives are discussed, as well as their potential impact on subsidence. Finally, recommendations are made for future studies aiming to reduce the risk of excessive subsidence in femoral impaction allografting.
全髋关节置换术中股骨部件的失败通常伴随着骨质流失，这会给骨科医生带来重大挑战。股骨打压植骨术在恢复股骨骨量方面具有诱人的潜力。然而，有报道称该手术术后出现假体柄下沉的问题。患者之间的下沉情况差异很大，对于导致下沉的机制也存在分歧。本文回顾了可能导致股骨打压植骨术中下沉的各种机制。讨论了诸如植骨密度、骨水泥渗透情况、合成植骨替代物的使用或其他植骨添加剂等变量，以及它们对下沉的潜在影响。最后，针对旨在降低股骨打压植骨术中过度下沉风险的未来研究提出了建议。
