[目的]探讨应用非骨水泥型组配式S-ROM假体行初次全髋关节置换术治疗严重髋关节发育不良的近期疗效。[方法]对18例（19髋）严重髋关节发育不良患者应用S-ROM假体行初次全髋关节置换术。其中男性6例,女性12例,平均年龄32岁。按Crowe分型,...[目的]探讨应用非骨水泥型组配式S-ROM假体行初次全髋关节置换术治疗严重髋关节发育不良的近期疗效。[方法]对18例（19髋）严重髋关节发育不良患者应用S-ROM假体行初次全髋关节置换术。其中男性6例,女性12例,平均年龄32岁。按Crowe分型,CroweⅢ型11例11髋,CroweⅣ型7例8髋。手术采用在真臼位置磨锉加深重建髋臼,股骨侧选用S-ROM组配式假体,复位困难者行转子下截骨。术前和术后随访时应用Harris髋关节评分（Harris hip score,HHS）和影像学检查对髋关节功能进行评估。[结果]术中1例股骨近端裂缝骨折,用双股钢丝环扎固定。术后有2例出现坐骨神经牵拉症状,术后3个月内完全恢复。所有患者均得到有效随访,有1例患者大转子上方发生异位骨化,但不影响关节活动度,未发现感染、骨质溶解、假体松动、脱位等并发症。平均随访2.8年（6个月-5年）。HHS评分由术前平均38.4分增加到末次随访时的85.2分。[结论]S-ROM假体是治疗严重髋关节发育不良的理想选择,近期效果良好。展开更多
目的总结S-ROM(Sivash-range of motion femoral modular stem)假体设计及生物力学特点,以及在髋关节发育不良(developmental dysplasia of hip,DDH)的关节置换及髋关节翻修术中的应用进展。方法广泛查阅近年S-ROM假体的相关文献,并进...目的总结S-ROM(Sivash-range of motion femoral modular stem)假体设计及生物力学特点,以及在髋关节发育不良(developmental dysplasia of hip,DDH)的关节置换及髋关节翻修术中的应用进展。方法广泛查阅近年S-ROM假体的相关文献,并进行综合分析。结果 S-ROM假体利用其组配性可以在股骨近端与远端同时达到紧密压配,适用于存在股骨解剖差异以及需行股骨截骨矫形的DDH人工全髋关节置换,以及伴骨缺损的髋关节翻修。结论 S-ROM假体组配结合部增大了假体折断及产生金属磨屑的可能,其远期疗效需进一步随访明确。展开更多
BACKGROUND The uncemented ArcosTM Modular Femoral Revision System(ARCOS)is a new comprehensive,press-fit revision design.The modular design offers a wide range of possible combinations to accommodate different variati...BACKGROUND The uncemented ArcosTM Modular Femoral Revision System(ARCOS)is a new comprehensive,press-fit revision design.The modular design offers a wide range of possible combinations to accommodate different variations of anatomy and bone stock.The ARCOS is made by a proximal body and a distal stem.As probably the only ones worldwide we predominantly use a combination of body and stem which supports proximal fixation and load,since this mimics the concept of the primary total hip arthroplasty with proximal weight-bearing,leading to bone stock preservation and no stress shielding or thigh pain.AIM To evaluate the early results after femoral revision in a consecutive series of patients undergoing surgery over 3 years.METHODS We included 116 patients in the study.They were operated in the period August 2011 to December 2014 and we got a clinical mean observation time of 4(0.5-6)years.Clinical and radiographical follow-up included present function of the hip assessed by Harris Hip Score,Oxford Hip Score,and EQ5D(measure of health outcome).Of the 116 patients,17 died in the interim and were consequently included only in the implant survivorship analysis;46 patients attended the follow-up control.RESULTS In total 6(5%)hips were re-revised due to infection(n=3),fracture(n=2)or subsidence(n=1).No patient was re-revised due to aseptic loosening.The 1-,2-and 5-year probability of implant survival(95%CI)were 97%(93%-100%),97%(93%-100%)and 96%(92%-99%),respectively.In this cohort 95 patients received a combination of a proximal broach and a distal curved and slotted stem(BS),aiming for proximal fixation and load bearing;21 patients received a different combination.When comparing these two groups the BS-group had a 5-year implant survival probability(95%CI)of 97%(93%-100%)compared with the group of other combinations with a 5-year implant survival probability(95%CI)of 90%(78%-100%)(P=0.3).Our regression analysis showed that periprosthetic fracture as an indication for the ARCOS operation was the only significant negative outcome predictor.The mean Harris Hip Score result(100 points being best)was 83(range 5-98).The mean Oxford Hip Score result(48 points being best)was 40(range 19-48).CONCLUSION The early results of the ARCOS are promising compared with similar studies.We encourage the use of the BS combination whenever the bone stock proximally is adequate.展开更多
文摘[目的]探讨应用非骨水泥型组配式S-ROM假体行初次全髋关节置换术治疗严重髋关节发育不良的近期疗效。[方法]对18例（19髋）严重髋关节发育不良患者应用S-ROM假体行初次全髋关节置换术。其中男性6例,女性12例,平均年龄32岁。按Crowe分型,CroweⅢ型11例11髋,CroweⅣ型7例8髋。手术采用在真臼位置磨锉加深重建髋臼,股骨侧选用S-ROM组配式假体,复位困难者行转子下截骨。术前和术后随访时应用Harris髋关节评分（Harris hip score,HHS）和影像学检查对髋关节功能进行评估。[结果]术中1例股骨近端裂缝骨折,用双股钢丝环扎固定。术后有2例出现坐骨神经牵拉症状,术后3个月内完全恢复。所有患者均得到有效随访,有1例患者大转子上方发生异位骨化,但不影响关节活动度,未发现感染、骨质溶解、假体松动、脱位等并发症。平均随访2.8年（6个月-5年）。HHS评分由术前平均38.4分增加到末次随访时的85.2分。[结论]S-ROM假体是治疗严重髋关节发育不良的理想选择,近期效果良好。
文摘BACKGROUND The uncemented ArcosTM Modular Femoral Revision System(ARCOS)is a new comprehensive,press-fit revision design.The modular design offers a wide range of possible combinations to accommodate different variations of anatomy and bone stock.The ARCOS is made by a proximal body and a distal stem.As probably the only ones worldwide we predominantly use a combination of body and stem which supports proximal fixation and load,since this mimics the concept of the primary total hip arthroplasty with proximal weight-bearing,leading to bone stock preservation and no stress shielding or thigh pain.AIM To evaluate the early results after femoral revision in a consecutive series of patients undergoing surgery over 3 years.METHODS We included 116 patients in the study.They were operated in the period August 2011 to December 2014 and we got a clinical mean observation time of 4(0.5-6)years.Clinical and radiographical follow-up included present function of the hip assessed by Harris Hip Score,Oxford Hip Score,and EQ5D(measure of health outcome).Of the 116 patients,17 died in the interim and were consequently included only in the implant survivorship analysis;46 patients attended the follow-up control.RESULTS In total 6(5%)hips were re-revised due to infection(n=3),fracture(n=2)or subsidence(n=1).No patient was re-revised due to aseptic loosening.The 1-,2-and 5-year probability of implant survival(95%CI)were 97%(93%-100%),97%(93%-100%)and 96%(92%-99%),respectively.In this cohort 95 patients received a combination of a proximal broach and a distal curved and slotted stem(BS),aiming for proximal fixation and load bearing;21 patients received a different combination.When comparing these two groups the BS-group had a 5-year implant survival probability(95%CI)of 97%(93%-100%)compared with the group of other combinations with a 5-year implant survival probability(95%CI)of 90%(78%-100%)(P=0.3).Our regression analysis showed that periprosthetic fracture as an indication for the ARCOS operation was the only significant negative outcome predictor.The mean Harris Hip Score result(100 points being best)was 83(range 5-98).The mean Oxford Hip Score result(48 points being best)was 40(range 19-48).CONCLUSION The early results of the ARCOS are promising compared with similar studies.We encourage the use of the BS combination whenever the bone stock proximally is adequate.
