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翻修全髋关节置换术中困难的髋关节假体术中脱位技术

A Technique for Difficult Intraoperative Dislocation of Hip Prosthesis in Revision Total Hip Arthroplasty.

作者信息

Johnson Philip K, Lapow Justin, Grant Andrew R, Lementowski Peter

机构信息

Orthopedic Surgery, New York Medical College, Valhalla, USA.

Orthopedic Surgery, Westchester Medical Center, Valhalla, USA.

出版信息

Cureus. 2024 Jul 28;16(7):e65600. doi: 10.7759/cureus.65600. eCollection 2024 Jul.

DOI:10.7759/cureus.65600
PMID:39205764
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11349717/
Abstract

There are instances where a patient's prosthetic hip is unable to be dislocated intraoperatively during a conversion or revision arthroplasty, despite scar removal and standard dislocation maneuvers. We describe a technique that involves an in situ disassociation of the femoral head component from the trunnion without the need for additional osteotomies. This maneuver may be beneficial in cases of protrusio, muscular stiffness, high soft tissue tension, arthrofibrosis, and ankylosis due to heterotopic ossification, as well as cases that involve a large femoral head or acetabular constraint. We also present a case of a 61-year-old male with a chronic prosthetic hip infection who underwent a two-stage revision surgery where this technique was utilized.

摘要

在某些情况下，尽管进行了瘢痕切除和标准的脱位操作，但在关节置换翻修术中，患者的人工髋关节在术中仍无法脱位。我们描述了一种技术，该技术涉及在不进行额外截骨的情况下将股骨头组件与耳轴原位分离。对于髋臼内陷、肌肉僵硬、软组织张力高、关节纤维性粘连以及由于异位骨化导致的关节强直的病例，以及涉及大股骨头或髋臼受限的病例，这种操作可能是有益的。我们还介绍了一例61岁男性慢性人工髋关节感染患者，该患者接受了两阶段翻修手术，术中使用了这项技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/11349717/1b862830930a/cureus-0016-00000065600-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/11349717/23301d8173f8/cureus-0016-00000065600-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/11349717/3248c0c6a633/cureus-0016-00000065600-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/11349717/b2cfcb86f315/cureus-0016-00000065600-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/11349717/1b862830930a/cureus-0016-00000065600-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/11349717/23301d8173f8/cureus-0016-00000065600-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/11349717/3248c0c6a633/cureus-0016-00000065600-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/11349717/b2cfcb86f315/cureus-0016-00000065600-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/11349717/1b862830930a/cureus-0016-00000065600-i04.jpg

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Practical Surgical Techniques for Revision Total Hip Arthroplasty.
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