Moga M, Pogarasteanu M E
Orthopedics - Traumathology Clinic, "Dr. Carol Davila" Central Military University Emergency Hospital, Bucharest, Romania.
J Med Life. 2014 Sep 15;7(3):403-7. Epub 2014 Sep 25.
Primary hip arthroplasty is a surgical procedure through which the coxofemoral joint is replaced with a prosthetic implant. Arthroplasties can be total or partial, cemented or uncemented. These procedures are generally indicated as a form of treatment for arthritic pain or in the case of severe trauma, such as femoral neck fractures. The most commonly used approaches are: Smith Peterson, Watson Jones, Hardinge, Moore Southern and Ludloff. Recently, mini-invasive approaches have started being used, while correlated with short femoral stems. Short metaphyseal femoral stems have been introduced as an alternative to conventional stems, having a series of advantages: preservation of bone stock (high cervical osteotomies), preservation of the anatomical anteversion of the femural neck, decrease in cortical stress forces, decrease in the remaining thigh pain, a longer life of the prosthesis, with the possibility of revision to a conventional prosthesis, and the possibility to be used in correlation with mini-invasive procedures. Short femoral stems implanted through a mini-invasive approach allow the conservation of the femoral bone stock, permitting an ulterior re-intervention, in the context of an ageing population, with a globally rising long-term survival rate. Moreover, the superiority of the total hip arthroplasty with a short femoral stem was discussed through mini-invasive approaches, in the day-to-day realities of our Clinic.
初次髋关节置换术是一种通过用假体植入物替换髋关节来进行的外科手术。关节置换术可以是全髋关节置换或半髋关节置换,也可以是骨水泥型或非骨水泥型。这些手术通常作为治疗关节炎疼痛的一种方式,或者用于严重创伤的情况,如股骨颈骨折。最常用的手术入路有:史密斯-彼得森入路、沃森-琼斯入路、哈丁格入路、摩尔南方入路和卢德洛夫入路。最近,微创入路开始被使用,同时与短柄股骨假体相关联。短柄干骺端股骨假体已作为传统假体的替代品被引入,具有一系列优点:保留骨量(高位颈骨截骨术)、保留股骨颈的解剖前倾、降低皮质骨应力、减轻大腿残留疼痛、延长假体使用寿命、有可能翻修为传统假体,以及有可能与微创操作联合使用。通过微创入路植入的短柄股骨假体能够保留股骨骨量,在人口老龄化的背景下,随着长期生存率的全球上升,允许进行后续再次干预。此外,在我们诊所的日常实际情况中,还通过微创入路讨论了短柄股骨假体全髋关节置换术的优越性。