Sokolovsky A V, Sokolovsky V A, Aliev M D
Vopr Onkol. 2016;62(6):848-856.
To investigate beneficial advantages of the ultrasonic method of bone cement removing in, compare with mechanical as well as to qualitatively improve the technology of bone cement removing in revision arthroplasty.
The study included 55 patients with benign, primary and metastatic malignant tumors. From March 2014 to January 2016 there were performed 56 revisions. In 36 cases revisions were made using ultrasound system <<Oscar Ultrasonic 3", mechanically the cement mantle was removed in 20 cases. The quality control of bone cement extraction was carried out by endoscopic stand <
Mean follow-up after surgery was 11.5 months. One patient had second revision after mechanical extraction of bone cement due to aseptic loosening. In the group of patients after ultrasonic extraction of the cement mantle deterioration of the cement fixation was not revealed. The average time.of surgery using ultrasonical and mechanical technology of bone cement removal was 154.5 and 158.1 min. in replacement of one stem, 200 and 182 min. in replacement of two stems respectively. The average blood loss was 427 and 430 ml. in a time of one stem revision, 445 and 525 ml in a time of two stem revision after using ultrasound and mechanical technol- ogy respectively. In one stem revision with using ultrasound extractor was achieved the reduction in blood loss at 10% and in two stem revision at 16%. There were no any complications in using ultrasonic extractor.
The use of ultrasonic technology in the re- vision arthroplasty can improve the quality of cement fixa- tion, reduce the amount of bleeding and severity of surgical treatment regardless of the surgery time, improve economic efficiency. Further enhancement of the ultrasonic method for cement mantle extraction has a potential to improve its effectiveness.
研究骨水泥清除超声方法相较于机械方法的有益优势，并定性改进翻修关节成形术中骨水泥清除技术。
该研究纳入了55例患有良性、原发性和转移性恶性肿瘤的患者。2014年3月至2016年1月期间进行了56次翻修手术。36例使用“奥斯卡超声3型”超声系统进行翻修，20例通过机械方式清除骨水泥套。通过“史托斯”内镜支架对骨水泥提取进行质量控制。通过放射学评估假体柄固定质量。
术后平均随访11.5个月。1例患者在机械清除骨水泥后因无菌性松动进行了二次翻修。在超声清除骨水泥套的患者组中，未发现骨水泥固定恶化情况。使用超声和机械技术清除骨水泥更换单个假体柄的平均手术时间分别为154.5分钟和158.1分钟，更换两个假体柄时分别为200分钟和182分钟。使用超声和机械技术进行单个假体柄翻修时平均失血量分别为427毫升和430毫升，两个假体柄翻修时分别为445毫升和525毫升。使用超声提取器进行单个假体柄翻修时失血量减少了10%，两个假体柄翻修时减少了16%。使用超声提取器未出现任何并发症。
在翻修关节成形术中使用超声技术可提高骨水泥固定质量，减少出血量和手术治疗的严重程度，且与手术时间无关，提高经济效益。进一步改进超声方法提取骨水泥套有可能提高其有效性。
