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在距骨引导下的短柄全髋关节置换术中的个体化柄部定位

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty.

作者信息

Kutzner Karl Philipp, Pfeil Joachim

机构信息

Department of Orthopaedic Surgery and Traumatology, St. Josefs Hospital Wiesbaden;

Department of Orthopaedic Surgery and Traumatology, St. Josefs Hospital Wiesbaden.

出版信息

J Vis Exp. 2018 Feb 27(132):56905. doi: 10.3791/56905.

Abstract

Bone- and soft-tissue sparing short stems are increasingly used in total hip arthroplasty (THA). However, there are a large variety of models of short stems, differing in design and function. Calcar-guided short stems provide an anatomical curvature in the medial calcar region, thus, positioning is done individually alongside the calcar in the "round-the-corner" technique. Depending on the level of the neck's osteotomy, stems can be aligned individually in a large bandwidth of varus- and valgus anatomies. This differs from conventional total hip arthroplasty and potentially includes a severe learning curve. Given that a great variety of caput-collum-diaphyseal (CCD)-angles can be retained, the reconstruction of femoro-acetabular offsets can be achieved precisely. However, particularly extensive varus- and valgus positioning has raised concerns in regard to stability and bone remodeling. The purpose of the present manuscript is to showcase the implantation technique in calcar-guided short-stem THA and to summarize short-term clinical and radiological results.

摘要

在全髋关节置换术(THA)中,保留骨与软组织的短柄假体应用日益广泛。然而,短柄假体型号繁多,设计与功能各异。股骨距导向短柄假体在内侧股骨距区域提供解剖学曲度,因此,采用“转角”技术沿股骨距单独进行定位。根据股骨颈截骨水平,假体可在大范围的内翻和外翻解剖结构中单独对齐。这与传统全髋关节置换术不同,且可能存在较大的学习曲线。鉴于能保留多种头颈骨干(CCD)角,可精确重建股骨髋臼偏移。然而,特别是广泛的内翻和外翻定位引发了对稳定性和骨重塑的担忧。本手稿旨在展示股骨距导向短柄全髋关节置换术的植入技术,并总结短期临床和影像学结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbde/5931422/efeeae5c6cd5/jove-132-56905-0.jpg

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