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定制关节间隔器(CUMARS):人工髋关节周围感染中骨膜反应的消退及股骨重塑

Custom-Made Articulating Spacer (CUMARS): The Resolution of Periosteal Reaction and Femur Remodelling in Periprosthetic Hip Infection.

作者信息

Wong Rosalind, Abbas Azlina A, Ayob Khairul A, Nasuruddin Haidar, Selvaratnam Veenesh

机构信息

Joint Reconstruction Unit (JRU) National Orthopedic Centre of Excellence for Research and Learning (NOCERAL) Department of Orthopedic Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MYS.

出版信息

Cureus. 2023 Jul 10;15(7):e41669. doi: 10.7759/cureus.41669. eCollection 2023 Jul.

Abstract

Periprosthetic joint infection (PJI) is one of the most common complications after total hip arthroplasty (THA). Two-stage revision surgery is one of the treatment options for PJI, however, it has been associated with poor patient tolerance, reduced patient mobility, and periarticular tissue contracture leading to difficulty during second-stage reconstruction. The custom-made articulating spacer (CUMARS) was developed to provide an alternative that is better tolerated and to reduce the complexity of second-stage reconstruction. This study details the treatment of a patient with PJI post-THA with significant periosteal reaction using a CUMARS construct, which enabled immediate post-operative weight bearing, eventual eradication of infection, restoration of femoral bone stock, and avoidance of second-stage reconstruction.

摘要

人工关节周围感染(PJI)是全髋关节置换术(THA)后最常见的并发症之一。两阶段翻修手术是PJI的治疗选择之一,然而,它与患者耐受性差、活动能力下降以及关节周围组织挛缩有关,导致二期重建困难。定制关节间隔器(CUMARS)的开发是为了提供一种耐受性更好的替代方案,并降低二期重建的复杂性。本研究详细介绍了一名THA术后发生PJI且伴有明显骨膜反应的患者使用CUMARS假体的治疗情况,该治疗使患者术后能够立即负重,最终根除感染,恢复股骨骨量,并避免了二期重建。

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