Koech Hilary, Lawrenz Joshua M, Mesko Daniel R, Molloy Robert M
Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Arthroplast Today. 2018 Feb 1;4(2):175-179. doi: 10.1016/j.artd.2017.12.006. eCollection 2018 Jun.
Revision total hip arthroplasty in the setting of severe femoral bone loss can be challenging, with salvage options often limited to modular tapered stems, allograft prosthetic composites, and megaprostheses. This case highlights a 79-year-old woman with 2 years of thigh pain who is 8 years status post a revision proximal femoral allograft prosthetic composite reconstruction. Radiographs demonstrated significant stem subsidence into the femoral condyle. In an attempt to avoid a total femoral replacement and spare her functioning native knee, a tibial cone was used in conjunction with a proximal femoral replacement to structurally fill the flaring femoral canal and serve as a stable pedestal for the megaprosthesis body and provide the potential for biologic ingrowth. At 12-month follow-up, she ambulates with a cane, and radiographs reveal stable implant position.
在严重股骨骨量丢失的情况下进行全髋关节翻修术具有挑战性，挽救方案通常限于模块化锥形柄、同种异体移植假体复合物和巨型假体。本病例重点介绍了一名79岁女性，她在近端股骨同种异体移植假体复合物重建术后8年出现大腿疼痛2年。X线片显示柄明显下沉至股骨髁。为避免进行全股骨置换并保留其功能正常的原生膝关节，使用了胫骨锥体联合近端股骨置换术，以在结构上填充扩张的股骨髓腔，并作为巨型假体主体的稳定基座，为生物性骨长入提供可能。在12个月的随访中，她拄着拐杖行走，X线片显示植入物位置稳定。
