摘要
[目的]报道应用组配式远端固定生物型假体翻修PaproskyⅢ型股骨近端骨缺损的手术要点及疗效：[方法]2003年5月-2006年10月应用MP、ZMR组配式股骨假体翻修PaproskyⅢ型股骨近端骨缺损9例，男5例，女4例．年龄39—65岁，平均57岁，术后随防时间8—34个月，平均19个月。翻修原因：7例为骨水泥固定假体松动、骨溶解，2例为珊瑚面假体无菌性松动：原手术到翻修时间最短4年，最长12年。依据Paprosky分型，ⅢA型5例，ⅢB型4例。[结果]Hanris评分：术前平均35分（28—54分），术后85分（70—90分）。7例弃拐行走，2例存在大腿疼痛．其中1例轻度疼痛伴下肢短缩2．5cm，需扶手杖行走，1例中度疼痛，扶单拐行走、跛行。本组随访过程中均无再松动、感染征象，1例发生假体下沉12mm，股骨柄远端无骨溶解现象。[结论]组配式远端固定生物型假体可较好完成PaproskyⅢ型股骨骨缺损的翻修，能达到初期及后期稳定。由于假体的假体柄与假体近端部分分开，使其植入变得容易，多部件组配可方便解决各种可能问题，如偏心距、前倾角、肢体长度等，明显简化了手术，且手术安全性好，是较理想的股骨翻修假体：
[ Objective] To report the mid-term results and main points of modular femoral prosthesis in total hip revision surgery for Paprosky type Ⅲ bone defect of the proximal femur. [ Method] Nine eases of Paprosky type Ⅲ bone defect of the proximal femur were treated with modular femoral prosthesis MP and ZMR from May 2003 to October 2006. There were 5 males and 4 females with the age range of 39 -65 years （mean age 57 years）. All the patients were followed up for 8 -34 months （mean 19 months ）. Causes for revision included loosening and osteolysis of primary cemented prosthesis in 7 ,and coral face prosthesis sterile loosening in 2. The shortest time from the last operation to the revision was 4 years,and the longest was 12 years. There were 5 of type Ⅲ A and 4 of type Ⅲ B according to the Paprosky bone defect classification. [ Result] The Harris score was 35 points （28 - 54） before operation and 85 （ 70 - 90） ＇after operation. Seven patients walked without the help of crutches,one had a mild pain in the thigh and a leg crispation of 2.5 centimeter, and the other having a medium pain in the thigh limping with a crutch. No significant loosening,infection or osteolysis of distal femur was found. One prosthesis sinking 12 mm in 1 case. [ Conclusion] Total hip revision surgel2y for Paprosky type Ill femoral bone defect using modular femoral prosthesis has optimal mid-term results. It offers stabilization both in the initial and late stages. Due to the separation of prosthetic stem front the proximal prosthesis,the implantation is easy to fix. Modular femoral prosthesis,which is benificial to control offset, anteversion angle,and limb length makes lhe total hip revision surgeD simpler and safer.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2008年第16期1204-1206,共3页
Orthopedic Journal of China
关键词
组配式股骨假体
股骨近端骨缺损
翻修术
modular femoral prosthesis
bone defect of proximal femur
revision
