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翻修全肘关节置换术中取出固定良好的植入物和骨水泥的技术。

Techniques for removal of well-fixed implants and cement in revision total elbow arthroplasty.

作者信息

Koshinski Jessica L, Luciani A Michael, Ozdag Yagiz, Baylor Jessica L, Grandizio Louis C

机构信息

Geisinger MSKI Department of Orthopaedic Surgery, Geisinger Commonwealth School of Medicine, Danville, PA, USA.

出版信息

JSES Rev Rep Tech. 2024 Jun 16;4(4):720-726. doi: 10.1016/j.xrrt.2024.05.011. eCollection 2024 Nov.

Abstract

Revision total elbow arthroplasty (rTEA) is a technically challenging procedure that is associated with high rates of surgical complications. Cement removal remains an important and difficult component of rTEA. Particularly in the case of prosthetic joint infection following TEA, failure to remove all of the cement from the index procedure results in higher rates of recurrent or persistent infection. Options for cement removal include the use of nonpowered instruments, powered instruments, ultrasonic devices, arthroscopic-assisted techniques, bone episiotomies, and cortical windows. Carefully assessing the risks and benefits of each of these techniques can provide aid in both improving surgical efficiency and potentially reducing surgical morbidity during these complex procedures. The purpose of this narrative review was to explore technical aspects of cement removal for well-fixed implants during rTEA.

摘要

全肘关节翻修术(rTEA)是一项技术上具有挑战性的手术,伴有较高的手术并发症发生率。取出骨水泥仍然是rTEA的一个重要且困难的部分。特别是在全肘关节置换术后发生假体关节感染的情况下,若未能从初次手术中清除所有骨水泥,会导致更高的复发或持续感染率。骨水泥取出的方法包括使用手动器械、动力器械、超声设备、关节镜辅助技术、骨切开术和皮质骨开窗术。仔细评估这些技术各自的风险和益处,有助于在这些复杂手术中提高手术效率并可能降低手术并发症发生率。本叙述性综述的目的是探讨在rTEA过程中取出固定良好的植入物骨水泥的技术方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3122/11514084/7030152a4870/gr1.jpg

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