Masterson E L, Masri B A, Duncan C P
Department of Orthopaedics, Vancouver Hospital and Health Sciences Centre, Vancouver, British Columbia, Canada.
J Am Acad Orthop Surg. 1998 Mar-Apr;6(2):84-92. doi: 10.5435/00124635-199803000-00002.
Revision hip arthroplasty will be performed with frequency in the future. A successful outcome depends on careful preoperative planning, and a key component of that plan is the surgical approach. The choice of the approach should be based on the indication for revision, the particular implant to be removed, the presence of acetabular or femoral bone loss, previous surgical approaches used, and the preferences and training of the surgeon. For simple revision procedures, one of the standard approaches used in primary hip arthroplasty may be adequate. More complex cases may necessitate an extended exposure or one of the techniques developed specifically for revision arthroplasty. No single approach is suitable for all revision procedures, and the surgeon must be familiar with a range of exposures if the clinical result is to be optimized.
翻修髋关节置换术在未来将会更频繁地开展。手术成功的关键在于术前的精心规划,而该规划的一个关键要素就是手术入路。入路的选择应基于翻修的指征、需取出的特定植入物、髋臼或股骨骨质缺损的情况、既往使用的手术入路以及外科医生的偏好和经验。对于简单的翻修手术,初次髋关节置换术中使用的标准入路之一可能就足够了。更复杂的病例可能需要扩大显露范围或采用专门为翻修关节置换术开发的技术之一。没有一种单一的入路适用于所有的翻修手术,如果要优化临床效果,外科医生必须熟悉一系列的显露方法。