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[人工关节周围髋臼骨折]

[Periprosthetic Acetabulum Fractures].

作者信息

Schreiner A J, Stuby F, de Zwart P M, Ochs B G

机构信息

Klinik für Unfall- und Wiederherstellungschirurgie, BG-Unfallklinik Tübingen.

出版信息

Z Orthop Unfall. 2016 Dec;154(6):560-570. doi: 10.1055/s-0042-113196. Epub 2016 Oct 6.

Abstract

In contrast to periprosthetic fractures of the femur, periprosthetic fractures of the acetabulum are rare complications - both primary fractures and fractures in revision surgery. This topic is largely under-reported in the literature; there are a few case reports and no long term results. Due to an increase in life expectancy, the level of patients' activity and the number of primary joint replacements, one has to expect a rise in periprosthetic complications in general and periprosthetic acetabular fractures in particular. This kind of fracture can be intra-, peri- or postoperative. Intraoperative fractures are especially associated with insertion of cementless press-fit acetabular components or revision surgery. Postoperative periprosthetic fractures of the acetabulum are usually related to osteolysis, for example, due to polyethylene wear. There are also traumatic fractures and fractures missed intraoperatively that lead to some kind of insufficiency fracture. Periprosthetic fractures of the acetabulum are treated conservatively if the implant is stable and the fracture is not dislocated. If surgery is needed, there are many possible different surgical techniques and challenging approaches. That is why periprosthetic fractures of the acetabulum should be treated by experts in pelvic surgery as well as revision arthroplasty and the features specific to the patient, fracture and prosthetic must always be considered.

摘要

与股骨假体周围骨折不同,髋臼假体周围骨折是罕见的并发症——包括初次骨折和翻修手术中的骨折。该主题在文献中报道较少;仅有少数病例报告,且无长期结果。由于预期寿命增加、患者活动水平提高以及初次关节置换数量增多,总体上假体周围并发症尤其是假体周围髋臼骨折预计会增加。这类骨折可发生在术中、术后或围手术期。术中骨折尤其与非骨水泥压配型髋臼组件的植入或翻修手术有关。髋臼术后假体周围骨折通常与骨溶解有关,例如由于聚乙烯磨损。也有创伤性骨折以及术中漏诊的骨折,这些会导致某种应力性骨折。如果植入物稳定且骨折未脱位,髋臼假体周围骨折可采用保守治疗。如果需要手术,有许多可能不同的手术技术和具有挑战性的方法。这就是为什么髋臼假体周围骨折应由骨盆手术专家以及翻修关节成形术专家进行治疗,并且必须始终考虑患者、骨折和假体的特定特征。

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