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复杂翻修全髋关节置换术血管受累的术前优化

Preoperative optimization for vascular involvement complicating revision total hip arthroplasty.

作者信息

Asemota Daniel, Passano Brandon, Feng James E, Novikov David, Anoushiravani Afshin A, Schwarzkopf Ran

机构信息

Division of Adult Reconstructive Surgery, NYU Langone Orthopedics, NYU Langone Health, New York, NY, USA.

出版信息

Arthroplast Today. 2018 Mar 21;4(4):411-416. doi: 10.1016/j.artd.2018.02.003. eCollection 2018 Dec.

Abstract

UNLABELLED

Vascular complications in revision total hip arthroplasty may occur in cases where the components of the hip implant migrate through the acetabular wall, through the iliopectineal line of the pelvis, and into the pelvic cavity. This migration may lead to substantial intrapelvic vascular compromise, drastically increasing the surgical complexity and potential risk for morbidity and mortality in these surgical cases. Here, we present a case of a 78-year-old woman with significant acetabular protrusio, which resulted in intraoperative compromise of the external iliac artery with rapid extravasation. As a result of prudent preoperative planning, interdisciplinary collaboration, and precautionary measures, significant patient morbidity and mortality was averted.

LEVEL OF EVIDENCE

Level V, Case Report.

摘要

未标注

在翻修全髋关节置换术中,当髋关节植入物组件穿过髋臼壁、穿过骨盆的髂耻线并进入盆腔时,可能会发生血管并发症。这种移位可能导致盆腔内血管严重受损,极大地增加了这些手术病例的手术复杂性以及发病和死亡的潜在风险。在此,我们报告一例78岁女性髋臼明显前突的病例,该病例术中导致髂外动脉受损并迅速出血。由于术前进行了谨慎的规划、多学科协作以及采取了预防措施,避免了患者出现严重的发病和死亡情况。

证据级别

V级,病例报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3d4/6287237/322c5190def0/gr1.jpg

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