Modular noncemented total hip arthroplasty for congenital dislocation of the hip. Case report and design rationale.
Modular noncemented total hip arthroplasty for congenital dislocation of the hip. Case report and design rationale.
复制标题
模块化非骨水泥全髋关节置换术治疗先天性髋关节脱位。
DOI：
10.1097/00003086-198803000-00017
复制
发表时间：
1988
影响因子：
4.2
通讯作者：
J. Gorski
中科院分区：
文献类型：
--
作者：
J. Gorski
全髋关节置换术中失败率最高、技术难度最大的是先天性髋关节脱位(CDH)。易感因素是无法固定特殊的股骨假体，以适应极其狭窄和笔直的髓腔，而骨髓腔的空间只能容纳非常薄的骨水泥。髋臼通常萎缩，通常需要植骨来支撑小直径的杯子。普通患者的年轻年龄和高水平的活动是水泥失败的原因之一。一种新型的模块化非骨水泥假体为CDH患者提供了出色的即刻骨骼固定和疼痛缓解。五个模块化组件被拧紧或压入骨中。模块化方法便于植入，减少库存，并能适应不可预见的问题。对于标准或定制的粘结件，这些优势通常是不存在的。模块化组件还可以更容易地进行修改。该假体由钛合金制成，具有高温合金强度、弹性模量和生物惰性。通过省略水泥外罩，可以获得尽可能大的种植体的压合。大尺寸可以最大限度地减少这些年轻、小骨骼的断茎。良好的短期结果表明，模块化非骨水泥植入物适用于部分CDH患者。
The highest rate of failure and the greatest technical difficulty in total hip arthroplasty occurs with congenital dislocation of the hip (CDH). Predisposing factors are failure to secure special femoral components to fit an extremely narrow and straight medullary cavity with space for only a very thin mantle of cement. The acetabulum is usually atrophic, and bone grafts are commonly required to support a small-diameter cup. The young age of the average patient and high levels of activity contribute to cement failure. A new modular cementless prosthesis provides excellent immediate skeletal fixation and pain relief in CDH patients. Five modular components are screwed or press-fit into bone. The modular approach facilitates implantation, reduces inventory, and is adaptable to unforeseen problems. These advantages are ordinarily absent with standard or custom cemented components. Modular components may also permit easier revision. The prosthesis is made of titanium alloy for its superalloy strength, elastic modulus, and bioinertness. By omitting the cement mantle, press-fit is obtained with the largest possible implant. The large size minimizes stem breakage in these young, small bones. Excellent short-term results suggest that modular cementless implants are indicated in some patients with CDH.