Corces Arturo, Heifner John, Zavurov Gabriel
Larkin Hospital Department of Orthopaedic Surgery, Coral Gables, FL, USA.
St George's University College of Medicine, Greta River, NY, USA.
Arthroplast Today. 2023 Jan 18;19:101089. doi: 10.1016/j.artd.2022.101089. eCollection 2023 Feb.
Complex periprosthetic fractures may occur with existing ipsilateral hip and knee implants. These cases are challenging with few options. We report on a custom coupler used to connect a hinged distal femoral replacement to an existing revision hip stem. This option was preferred to a total replacement of the femur. The custom coupler maintained the anatomic attachments of the proximal femur, preserved abductor strength during ambulation, and mitigated the morbidity which may arise from a total femur replacement. At 15 months postoperatively, the patient reported no pain, did not demonstrate an antalgic gait pattern, and had satisfactory range of motion at the hip and knee. The literature displays clinical and biomechanical efficacy for coupling devices although complications and device failure are quite variable.
复杂的假体周围骨折可能发生在同侧现有的髋关节和膝关节植入物的情况下。这些病例具有挑战性，选择很少。我们报告了一种定制的连接器，用于将铰链式股骨远端置换物与现有的翻修髋关节柄连接。这种选择优于全股骨置换。定制连接器保持了股骨近端的解剖附着，在行走过程中保留了外展肌力量，并减轻了全股骨置换可能引起的发病率。术后15个月，患者报告无疼痛，未表现出止痛步态模式，髋关节和膝关节的活动范围令人满意。尽管并发症和器械故障差异很大，但文献显示了连接装置的临床和生物力学疗效。
