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來源資料
頁籤選單縮合
題 名 | Proximal Femoral Megaprosthesis for Failed Total Hip Arthroplasty=股骨近端人工關節用於失敗的全人工髖關節置換 |
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作 者 | 史書泰; 王俊聞; 許家禎; | 書刊名 | 長庚醫學 |
卷 期 | 30:1 2007.01-02[民96.01-02] |
頁 次 | 頁73-80 |
分類號 | 416.61 |
關鍵詞 | 巨大人工關節; 近端股骨置換; 全人工關節置換; Megaprosthesis; Proximal femoral replacement; Total hip arthroplasty; |
語 文 | 英文(English) |
中文摘要 | 背景:本回溯性研究的目的在於評估全人工髖關節置換後導致股骨缺損,而以股骨近端人工關節重建的臨床結果及其併發症。 方法:由1997年至2002年間,有12例(12髖關節)以股骨近端人工關節來重建失敗的全人工髖關節,病人平均年齡為59歲,12例中有8例因感染,另外4例因非感染引致全人工髖關節鬆脫,平均股骨近端人工關節置換長度為15.6公分。 結果:平均追蹤時間為5.7年(範圍,3.3至9年),8例(67%)得到滿意結果,1例一般(fair),3例最差(poor)。併發症包括感染(33%),脫臼(42%),長短腳大於3公分(16.7%),大轉子移位(25%),異位骨化症(8%),股骨莖鬆脫(8%),手術前12例平均HHS評分為30分(範圍,16至42分),9例骨股近端人工關節仍保留者平均HHS評分為83分(範圍,68至92分)。 結論:如果沒有其他更好的方法。全人工髖關節失敗後導致大量股骨缺損,以股骨近端人工關節來重建,是一個好方法。然而,此種手術技術層面高而且術後併發症較高,術後使用外展支架可減少脫臼機率。 |
英文摘要 | Background: The purpose of this study was to assess the clinical outcome and complications of megaprostheses for massive proximal femoral bone loss after failed total hip arthroplasty. Methods: Between June 1997 and December 2002, 12 patients (12 hips) with massive proximal femoral deficiencies had reconstruction of the hip using proximal femoral megaprostheses. The average age of the patients was 59 years (range 25 to 75). Results: At an average of 5.7 years (range 3.3 to 9) after surgery, eight patients (67%) had a satisfactory result, one had fair and three had poor results. The complications included dislocation in 5 (42%), deep infection in 4 (33%), ectopic ossification in 1 (8%), leg shortening > 3 cm in 2 (16.7%), displacement of the greater trochanter in 3 (25%) and aseptic loosening of the megaprosthesis in 1 (8%). The early dislocation rate was 75% but this was subsequently reduced to 14% in the later period after use of an abduction brace postoperatively. The average Harris hip score of the 12 patients preoperatively was 30 points (range 16-42). The average Harris hip score of the 9 patients with a retained megaprosthesis was 83 points (range 68 to 92). Conclusion: Patients with a failed total hip arthroplasty and massive proximal femoral bone loss can be salvaged with a proximal femoral megaprosthesis if there is no other alternative. However, this procedure is technically demanding and has a high rate of complications. The routine use of an abduction brace postoperatively is advised to reduce the dislocation rate. |
本系統中英文摘要資訊取自各篇刊載內容。