Thorat Babaji, Singh Avtar, Vohra Rajeev
Department of Orthopaedic Surgery, Amandeep Hospital, Amritsar, 143001, India.
J Clin Orthop Trauma. 2020 Oct 6;14:29-33. doi: 10.1016/j.jcot.2020.09.033. eCollection 2021 Mar.
Choice of the implant during revision total hip arthroplasty (THA) is crucial in younger patients due to the impaired quality of bone and deficient bone stock. The short femoral stem provides an appealing unorthodox alternative implant in young patients undergoing primary total hip arthroplasty. A classic revision total hip arthroplasty predominantly describes the use of conventional or long stem for revision of the femoral component. However, little is known about the use of short femoral stem in revision THA. This case report discusses the revision of cemented conventional femoral stem using a bone-conserving short-stem femoral implant with circumferential metaphyseal fixation, which is seldom reported in the literature. Associated benefits are less aggressive surgery with a reduction in blood loss, magnitude and duration of surgery by avoiding the removal of distal cement in the femur canal, thus making the femoral component revision easier. Moreover, it facilitates postoperative rehabilitation and recovery as well. Also, it preserves the femoral bone stock and offers a long term solution especially in young patients retaining the choice of using a conventional or long stem femoral implant should a second revision becomes imperative.
在翻修全髋关节置换术（THA）中，由于骨质量受损和骨量不足，对于年轻患者而言，植入物的选择至关重要。短柄股骨假体为接受初次全髋关节置换术的年轻患者提供了一种引人注目的非传统替代植入物。经典的翻修全髋关节置换术主要描述使用传统或长柄股骨假体来翻修股骨部件。然而，对于短柄股骨假体在翻修THA中的应用知之甚少。本病例报告讨论了使用具有周向干骺端固定的保骨短柄股骨植入物对骨水泥固定的传统股骨柄进行翻修，这在文献中鲜有报道。相关益处包括手术创伤较小，通过避免去除股骨髓腔内的远端骨水泥，减少了失血量、手术规模和手术时间，从而使股骨部件的翻修更加容易。此外，它还便于术后康复和恢复。而且，它保留了股骨骨量，并提供了一个长期解决方案，特别是对于年轻患者而言，如果必须进行二次翻修，仍可选择使用传统或长柄股骨植入物。
