Combined use of extensively porous coated femoral components with onlay cortical strut allografts in revision of Vancouver B2 and B3 periprosthetic femoral fractures
Combined use of extensively porous coated femoral components with onlay cortical strut allografts in revision of Vancouver B2 and B3 periprosthetic femoral fractures
复制标题
结合使用广泛多孔涂层股骨组件与同种异体骨皮质支撑移植物修复温哥华 B2 和 B3 假体周围股骨骨折
DOI：
10.3760/cma.j.issn.0366-6999.2009.21.016
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发表时间：
2009-11-05
影响因子：
6.1
通讯作者：
Dai Xue-song
中科院分区：
文献类型：
--
作者：
Wu Hao-bo;Yan Shi-gui;Dai Xue-song
背景全髋关节置换术后股骨假体周围骨折越来越普遍。方法对13例13髋温哥华B2或B3型股骨假体周围骨折行全髋关节置换术后，应用非骨水泥型广泛多孔涂层股骨假体与同种异体皮质骨支架联合治疗，观察其临床效果。皮质骨支柱同种异体移植物。对每例患者进行Harris髋关节评分，并对疼痛和满意度进行视觉模拟量表（VAS）评分。X线片检查组件的稳定性，骨折部位和同种异体骨-宿主愈合和同种异体骨reconstruction.Results在平均5.3年的随访，没有病人需要重复修订。平均Harris髋关节评分为（71.8 ± 6.3）分，疼痛VAS评分为（16.6 ± 4.3）分，患者满意度VAS评分为（81.5 ± 5.7）分。X线片检查显示假体无松动，12例为骨结合固定，1例为纤维嵌固固定。所有骨折平均愈合时间为（5.2 ± 1.4）个月。结论非骨水泥型、长柄、多孔涂层种植体与同种异体皮质骨覆盖支架联合应用，可获得良好的临床效果，骨折愈合率和骨愈合率均较高。该技术可常规用于加强温哥华132和133例假体周围骨折的固定和愈合。中华医学杂志2009;122（21）：2612-2615
Background Periprosthetic femoral fractures following total hip arthroplasty are getting more prevalent. The aim of this study was to evaluate the clinical results of combined use of uncemented extensively porous coated femoral components with onlay cortical strut allografts in revision of Vancouver type B2 and B3 periprosthetic femoral fractures.Methods Thirteen hips after total hip arthroplasty in 13 patients who suffered a Vancouver B2 or B3 periprosthetic fracture were treated with an uncemented extensively porous coated femoral component combined with onlay cortical strut allografts. Each patient was assigned a Harris hip score, and a visual analog scale (VAS) score for pain and satisfaction. Radiographs were examined for component stability, fracture site and allograft-host union and allograft reconstruction.Results At an average of 5.3-year follow-up, no patient required repeat revision. The average Harris hip score was (71.8 +/- 6.3) points, the pain VAS score was (16.6 +/- 4.3) points, and the patient satisfaction VAS score was (81.5 +/- 5.7) points. Radiographic examination showed no detectable loosening of the prostheses, and 12 cases were presented fixation by osseointegration and the other one was stable fibrous ingrown fixation. All fractures united for (5.2 +/- 1.4) months in average. And all onlay strut allografts united to host bone for about (11.5 +/- 2.6) months.Conclusions Combined use of uncemented, long stemmed, extensively porous coated implant with cortical onlay strut allografts can achieve good clinic results and high rate of union for both fracture site and allograft-host bone junction. This technique could be used routinely to augment fixation and healing of Vancouver 132 and 133 periprosthetic fractures. Chin Med J 2009;122(21):2612-2615