非骨水泥全髋关节置换术在镰状细胞病中的应用：长期结果。
Noncemented Total Hip Arthroplasty in Sickle-Cell Disease: Long-Term Results.
机构信息
Department of Orthopedic Surgery, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Alfaisal University, College of Medicine, Riyadh, Saudi Arabia.
Department of Orthopedic Surgery, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
出版信息
J Arthroplasty. 2018 Feb;33(2):477-481. doi: 10.1016/j.arth.2017.09.010. Epub 2017 Sep 14.
BACKGROUND
Avascular necrosis of the femoral head is a well-known sequela of sickle-cell disease (SCD) requiring a surgical intervention that comes with technical challenges.
METHODS
Uncemented hip arthroplasty for avascular necrosis of the femoral head due to SCD was carried out for 101 patients (133 hips) between 2000 and 2012. The duration of follow-up ranged from 5 to 17 years (mean, 14.59 years). All patients received a noncemented femoral stem and a noncemented acetabular shell.
RESULTS
After surgery, all patients showed improvement in their hip scores for pain, range of motion, and function. The 10-year survivorship was 98%. There were 6 intraoperative fractures of the proximal femur (4.5%), 4 superficial and 5 deep infections (6.77%), 1 aseptic shell failure (0.75%), and 1 aseptic femoral stem failure (0.75%). Brooker grade IV heterotopic ossification developed in 5 hips (3.76%).
CONCLUSION
Hip arthroplasty in SCD is now a safe and effective procedure when the high rate of complications associated with this disease is given full consideration. With careful preoperative and postoperative planning, a highly successful outcome can be achieved. Noncemented shells and noncemented stems have shown durable long-term results.
背景
股骨头缺血性坏死是镰状细胞病（SCD）的一种已知后遗症，需要进行手术干预，这带来了技术挑战。
方法
2000 年至 2012 年间，对 101 例（133 髋）因 SCD 导致的股骨头缺血性坏死患者进行了非骨水泥髋关节置换术。随访时间为 5 至 17 年（平均 14.59 年）。所有患者均接受了非骨水泥股骨柄和非骨水泥髋臼杯。
结果
手术后，所有患者的髋关节疼痛、活动范围和功能评分均有所改善。10 年生存率为 98%。术中发生 6 例股骨近端骨折（4.5%），4 例浅表感染和 5 例深部感染（6.77%），1 例无菌性髋臼杯失败（0.75%）和 1 例无菌性股骨柄失败（0.75%）。5 髋出现布鲁克 4 级异位骨化（3.76%）。
结论
当充分考虑到与这种疾病相关的高并发症率时，SCD 患者的髋关节置换术现在是一种安全有效的手术。通过仔细的术前和术后规划，可以实现非常成功的结果。非骨水泥髋臼杯和非骨水泥股骨柄具有持久的长期效果。
Zotero 插件