Jumbo femoral head for the treatment of recurrent dislocation following total hip replacement
Jumbo femoral head for the treatment of recurrent dislocation following total hip replacement
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DOI：
10.2106/00004623-200202000-00013
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发表时间：
2002-02-01
影响因子：
5.3
通讯作者：
Amstutz, HC
中科院分区：
文献类型：
--
作者：
Beaule, PE;Schmalzried, TP;Amstutz, HC
背景资料：本研究的目的是评估结果的使用一个巨大的股骨头，以恢复稳定性髋关节持续复发脱位后全髋关节replacement.Methods：12髋关节在12例曾多次髋关节手术和复发性髋关节不稳定进行了全髋关节置换术与使用的股骨头，平均直径为44毫米（范围，40至50毫米）。患者的平均年龄为59岁（范围为29至84岁）。这12名患者平均有4次既往手术（范围：1 - 8次手术）和7次脱位（范围：2 - 20次脱位）。在10个髋关节中使用了双极股骨头，这些髋关节具有带固定（非组配式）股骨头的股骨柄，在2个髋关节中使用了组配式股骨头（单极）。(One首先使用双极股骨头治疗髋关节，然后使用单极股骨头治疗。）结果：1例患者术后14个月死于无关原因。髋关节在死亡前一直保持稳定。平均随访6.5年（范围：3.2 - 11.8年）后，其余11个髋关节中有10个没有再发生不稳定。1例髋关节在翻修后1周内脱位，需要进行翻修手术以重新定位髋臼部件。在翻修术后7.6年随访时，发现该髋关节稳定。还有4例再次手术：1例是因为聚乙烯断裂; 1例是因为骨水泥滞留在关节内; 1例是因为股骨柄松动相关疼痛; 1例是因为晚期血源性感染。术前和术后的加州大学在洛杉矶髋关节评分的系列，分别为7和9点疼痛，5和7点步行，4和6点的功能，和3和5点activity.Conclusions：一个巨大直径股骨头提供了稳定性和改善功能，而不影响活动范围的复发性脱位患者全髋关节置换术后。
Background: The purpose of this study was to assess the results of the use of a jumbo femoral head to restore stability in hips that had sustained recurrent dislocations after total hip replacement.Methods: Twelve hips in twelve patients who had had multiple hip operations and recurrent instability of the hip underwent a total hip replacement with use of a femoral head with an average diameter of 44 mm (range, 40 to 50 mm). The average age of the patients was fifty-nine years (range, twenty-nine to eighty-four years). The twelve patients had had an average of four previous operations (range, one to eight operations) and seven dislocations (range, two to twenty dislocations). A bipolar head was used in ten hips that had a femoral stem with a fixed (non-modular) head, and a modular head (unipolar) was used in two hips. (One hip was first treated with a bipolar head and then with a unipolar head.)Results: One patient died of unrelated causes fourteen months postoperatively. The hip had remained stable until the time of death. After an average duration of follow-up of 6.5 years (range, 3.2 to 11.8 years), ten of the remaining eleven hips had had no additional episodes of instability. One hip dislocated within one week after the revision, necessitating revision surgery to reposition the acetabular component. This hip was found to be stable at the time of follow-up 7.6 years after the revision. There were four other reoperations: one was done because of a fracture of the polyethylene; one, because of entrapment of cement within the articulation; one, because of pain related to loosening of the femoral stem; and one, because of late hematogenous infection. The preoperative and postoperative University of California at Los Angeles hip scores for the series were, respectively, 7 and 9 points for pain, 5 and 7 points for walking, 4 and 6 points for function, and 3 and 5 points for activity.Conclusions: A jumbo-diameter femoral head provided stability and improved function without compromising range of motion in patients with recurrent dislocations following total hip arthroplasty.