陶瓷轴承骨折的全髋关节翻修术：翻修病例最佳实践综述
Revision Total Hip Arthroplasty for Fractured Ceramic Bearings: A Review of Best Practices for Revision Cases.
作者信息
Rambani Rohit, Kepecs David M, Mäkinen Tatu J, Safir Oleg A, Gross Allan E, Kuzyk Paul R
机构信息
Department of Orthopaedics, United Lincolnshire Hospital NHS Trust, Boston, Lincolnshire, UK.
Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Mount Sinai Hospital, Toronto, ON, Canada.
出版信息
J Arthroplasty. 2017 Jun;32(6):1959-1964. doi: 10.1016/j.arth.2016.12.050. Epub 2017 Jan 4.
BACKGROUND
Total hip arthroplasty revision for a fractured ceramic bearing is rare but offers unique challenges. The purpose of this review was to provide a summary of existing literature on fractured ceramic bearings.
METHODS
Two authors performed a literature search of the MEDLINE OVID and PubMed databases with the following search terms: ceramic, fracture, total hip arthroplasty, and revision.
RESULTS
The search identified 228 articles of which 199 were selected for review.
CONCLUSIONS
It is mandatory to perform a complete synovectomy and thorough debridement of the fractured ceramic fragments. A well-fixed acetabular component should be removed if either the locking mechanism is damaged or the component is malpositioned. If the femoral stem taper is damaged, the femoral stem should be removed. However, if minimal damage is present, the femoral stem may be retained and revised using a fourth generation ceramic head with a titanium sleeve. Metal bearings should be avoided and revision with ceramic bearings should be performed whenever possible.
背景
因陶瓷轴承骨折而进行的全髋关节置换翻修术很少见，但面临独特挑战。本综述的目的是总结关于陶瓷轴承骨折的现有文献。
方法
两位作者使用以下检索词对MEDLINE OVID和PubMed数据库进行了文献检索：陶瓷、骨折、全髋关节置换术和翻修术。
结果
检索到228篇文章，其中199篇被选入综述。
结论
必须彻底切除滑膜并彻底清除骨折的陶瓷碎片。如果锁定机制受损或髋臼组件位置不当，应移除固定良好的髋臼组件。如果股骨干锥度受损，应移除股骨干。然而，如果损伤最小，股骨干可以保留，并使用带钛套筒的第四代陶瓷头进行翻修。应避免使用金属轴承，尽可能使用陶瓷轴承进行翻修。
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