髋关节翻修术中股骨近端重塑的流行率、风险因素和处理方法。

Prevalence, risk factors, and management of proximal femoral remodeling in revision hip arthroplasty.

机构信息

Panorama Orthopedics and Spine Center, Golden, Colorado, USA.

出版信息

J Arthroplasty. 2013 May;28(5):877-81. doi: 10.1016/j.arth.2012.10.001. Epub 2013 Mar 13.

DOI:10.1016/j.arth.2012.10.001

Abstract

The prevalence of, risk factors, and management of proximal femoral remodeling in revision total hip arthroplasty is unknown. Therefore, we reviewed the files of 200 consecutive femoral revision arthroplasties to study this phenomenon. Remodeling was considered present if a properly sized diaphyseal-engaging acrylic template had appropriate distal canal fill but lied within 2mm of the proximal lateral endosteal cortex (definition 1) or completely outside the femoral canal (definition 2) on anteroposterior femoral radiographs. The prevalence of remodeling was 42% by definition 1 and 21% by definition 2. The strongest risk factors were loose femoral components and more severe femoral bone loss. Orthopedic surgeons performing revision arthroplasty should be prepared to encounter remodeling as its presence can complicate femoral component revision.

摘要

在翻修全髋关节置换术中，股骨近端重塑的流行程度、危险因素和处理方法尚不清楚。因此，我们复习了 200 例连续股骨翻修病例的病历，以研究这一现象。如果适当大小的骨干贴合型丙烯酸模板具有适当的远端髓腔填充，但位于股骨侧皮质近端 2mm 以内（定义 1）或完全位于股骨髓腔外（定义 2），则认为存在重塑。根据定义 1，重塑的发生率为 42%，根据定义 2，发生率为 21%。最强的危险因素是股骨部件松动和更严重的股骨骨质丢失。行翻修关节置换术的矫形外科医生应该准备好应对重塑，因为它的存在可能会使股骨部件的翻修复杂化。