髋关节股骨侧翻修:原因、分型及不同修复技术的应用原则  

Femoral revision of the hip: reason, type and different techniques

作　　者：冯硕 查国春 郭开今 陈向阳 Feng Shuo;Zha Guo-chun;Guo Kai-jin;Chen Xiang-yang(Department of Orthopedics, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China)

机构地区：[1]徐州医科大学附属医院骨科,江苏省徐州市221000

出　　处：《中国组织工程研究》2018年第15期2396-2406,共11页Chinese Journal of Tissue Engineering Research

基　　金：江苏省青年医学人才项目(QNRC2016800);徐州市科技计划项目(KC16SL111);江苏省卫计委面上项目(H2017081);江苏省级社会发展重点项目(BE2015627)~~

摘　　要：背景:人工髋关节置换在临床上的广泛应用,取得了很好的临床疗效。但随着初次置换患者数量的逐年增加,髋关节翻修患者的数量也随之增加,然而髋关节翻修是髋部难度系数较大的手术之一,很具有挑战性。目的:综述髋关节股骨侧翻修的原因、股骨侧骨缺损分型、假体类型及其不同假体的临床疗效等,为髋关节股骨侧翻修提供参考。方法:检索中国知网CNKI、Pub Med数据库及Web of science数据库,检索时间为1975年1月至2017年8月,关键词为"Revision total hip arthroplasty,Femur revision,Cemented femoral revision,Cemenless femoral revision Reoperation,Porous-coated stems,Modular,tapered stem,Wagner SL revision Stem"。结果与结论:(1)共检索到文献1 041篇,阅读摘要进行筛选,排除研究目的与髋关节股骨侧翻修无关及重复研究,共纳入文献109篇,其中106篇英文文献及3篇中文文献,对于股骨侧翻修进行分析综述;(2)髋关节股骨侧翻修依然是未来关节科医生所面临的挑战,是不断努力攻克的方向,尽虽目前材料科学、手术技术飞速的发展,但只有分析股骨侧翻修的原因,明确对于股骨侧骨缺损分型,掌握不同缺损的处理方法及假体类型的应用原则,根据患者的年龄、活动量等情况有关制定合理的股骨侧翻修方案是股骨侧翻修获得成功的关键。BACKGROUND： Total hip arthroplasty has been widely used in clinical practice, and achieved good clinical efficacy. However, with the yearly increased number of patients receiving primary arthroplasty, the number of revision hip arthroplasty patients has increased. However, hip arthroplasty is one of the most difficult hip surgery, and it is challenging. OBJECTIVE： To review the causes of femoral revision of the hip arthroplasty, the classification of the femoral bone defect, and the type of prosthesis available in the clinical revision, and the clinical effect of the different prosthesis, so as to provide reference for femoral revision. METHODS： CNKI, Web of Science, and PubMed were searched for the literatures published between January 1975 and August 2017 with the key words of ＂Revision total hip arthroplasty, Femur revision, Cemented femoral revision, Cemenless femoral revision Reoperation, Porous-coated stems, Modular, tapered stem, Wagner SL revision Stem＂. RESULTS AND CONCLUSION： （1） A total of 1 041 articles were retrieved. After reading the abstract, unrelated and repeated studies were excluded. Finally, 109 studies were included. Of them, there were 106 English studies and 3 Chinese studies. Femoral revision was analyzed and summarized. （2） Femoral revision of the hip is still the future challenges facing the joint surgeon. We continue to strive to overcome the direction. Although the current material science and surgical technology are now rapidly developed, only the analysis of the reasons for the revision of the femoral side, identifying the femoral side bone defect classification, mastering the treatment of different defects and the application of the principle of prosthesis type, making reasonable femoral revision program is the key to success according to the patient＇s age and activity.

关 键 词：骨科植入物 人工假体 关节成型术 髋 髋关节置换翻修术 股骨侧翻修 翻修 假体 骨缺损 再手术 

分 类 号：R318[医药卫生—生物医学工程]