From the University of Pennsylvania (Dr. Sheth), Perelman School of Medicine, the University of Pennsylvania (Dr. Dattilo), Philadelphia, PA, and New York University Langone Medical Center (Dr. Schwarzkopf), Hospital for Joint Diseases, New York, NY.
J Am Acad Orthop Surg. 2018 Oct 15;26(20):717-726. doi: 10.5435/JAAOS-D-16-00723.
Hemiarthroplasty is a common procedure for treatment of displaced femoral neck fractures in low-demand patients. As hip fracture incidence continues to increase, the need for revision hemiarthroplasty is also expected to increase. Multiple etiologies can result in a failed hemiarthroplasty, including persistent pain, infection, instability, leg-length discrepancy, and trauma. Preoperative clinical, radiographic, and laboratory assessments are critical in determining the etiology of the painful hemiarthroplasty. The standard of care for surgical management of failed hemiarthroplasty is conversion to a total hip arthroplasty. However, establishing the etiology preoperatively is essential to planning before treating the failed hemiarthroplasty.
人工髋关节半置换术是低需求患者治疗股骨颈移位骨折的常见手术。随着髋部骨折发病率的持续增加,预计需要进行翻修人工髋关节半置换术的病例也将增加。多种病因可导致人工髋关节半置换术失败,包括持续性疼痛、感染、不稳定、肢体长度差异和外伤。术前的临床、影像学和实验室评估对于确定疼痛性人工髋关节半置换术的病因至关重要。对于失败的人工髋关节半置换术的手术治疗标准是转换为全髋关节置换术。然而,在治疗失败的人工髋关节半置换术之前,术前确定病因是至关重要的。