Singh Somesh P, Bhalodiya Haresh P
Department of Orthopaedics, Civil Hospital and B. J. Medical College, Ahmedabad, Gujarat, India.
Indian J Orthop. 2013 Jul;47(4):357-63. doi: 10.4103/0019-5413.114919.
As the number of total hip arthroplasties (THAs) performed increases, so do the number of required revisions. Impaction bone grafting with Wagner SL Revision stem is a good option for managing bone deficiencies arising from aseptic osteolysis. We studied the results of cementless diaphyseal fixation in femoral revision after total hip arthroplasty and whether there was spontaneous regeneration of bone stock in the proximal femur after the use of Wagner SL Revision stem (Zimmer, Warsaw, IN, USA) with impaction bone grafting.
We performed 53 hip revisions using impaction bone grafting and Wagner SL Revision stems in 48 patients; (5 cases were bilateral) for variety of indications ranging from aseptic osteolysis to preiprosthetic fractures. The average age was 59 years (range 44-68 years). There were 42 male and 6 female patients. Four patients died after surgery for reasons unrelated to surgery. 44 patients were available for complete analysis.
The mean Harris Hip Score was 42 before surgery and improved to 86 by the final followup evaluation at a mean point of 5.5 years. Of the 44 patients, 87% (n=39) had excellent results and 10% (n=5) had good results. The stem survival rate was 98% (n=43).
Short term results for revision THA with impaction bone grafting and Wagner SL revision stems are encouraging. However, it is necessary to obtain long term results through periodic followup evaluation, as rate of complications may increase in future.
随着全髋关节置换术（THA）数量的增加，所需翻修手术的数量也在增加。使用瓦格纳SL翻修柄进行打压植骨是处理无菌性骨溶解导致的骨缺损的一个好选择。我们研究了全髋关节置换术后股骨翻修中无水泥骨干固定的结果，以及使用瓦格纳SL翻修柄（美国印第安纳州华沙市的齐默公司生产）进行打压植骨后股骨近端骨量是否会自发再生。
我们对48例患者（5例为双侧）进行了53例使用打压植骨和瓦格纳SL翻修柄的髋关节翻修手术，适应证包括无菌性骨溶解至假体周围骨折等多种情况。平均年龄为59岁（范围44 - 68岁）。男性患者42例，女性患者6例。4例患者术后因与手术无关的原因死亡。44例患者可进行完整分析。
术前平均Harris髋关节评分是42分，在平均5.5年的最终随访评估时提高到了86分。在这44例患者中，87%（n = 39）结果优秀，10%（n = 5）结果良好。柄的生存率为98%（n = 43）。
使用打压植骨和瓦格纳SL翻修柄进行全髋关节置换翻修的短期结果令人鼓舞。然而，由于未来并发症发生率可能增加，有必要通过定期随访评估获得长期结果。
