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71.
P. Nikiforidis G. Ch. Babis N Papaioannou D. S. Korres T. Pantazopoulos 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》1997,7(1):23-26
Summary The management of displaced intracapsular fractures of the hip is still controversial because of the high incidence of complications after internal fixation or hemiarthroplasty. To avoid some of these complications we have used primary total hip replacement for independently mobile patients over 65 years of age.Of 49 patients who were interviewed an average of 4.6 years after total hip replacement, 81.6% had excellent or good results as assessed by the Harris Hip Score. At that time two hips had been revised and another converted to Girdlestone due to deep infection. The survival of the prostheses was at 5 years 91.3%.It is concluded that total hip replacement is an established method of management for a selected group of patients with this injury, but further prospective studies are needed in order to define the groups of patients that benefit the most. 相似文献
72.
全髋置换术对下肢短缩的治疗 总被引:1,自引:0,他引:1
目的:探讨全髋关节置换术对肢体短缩的纠正。方法:2000年2月~2002年12月,将30例接受单侧全髋关节置换术的患进行了研究:男19例,女12例。术前通过临床及对骨盆前后位X线片的测量评估双下肢不等长的程度,然后利用模板预测髋臼及股骨假体的置入位置,估计股骨颈的截骨水平以维持双下肢等长。术中先标记并测量股骨近端至髋臼上方两标记之间的距离,而后在术前估计的位置进行股骨颈截骨。置入假体试模之后再次测量两标记之间的距离和检查髋周软组织的张力、关节活动和drop-kick试验。最后通过调整股骨头假体颈部或头部长度进一步进行纠正。结果:22例肢体短缩2cm以上的病人中。术后双下肢等长(双下肢相差在1cm内)20例,2例仍有短缩,1例短3cm,另1例短1.5cm。8例肢体短缩在1~2cm的病人术后肢体完全等长。全部病人没有髋关节的僵硬和疼痛,活动范围恢复75%以上26例,恢复50%~75%4例。结论:通过术前测量评估,术中定位测量。术中软组织充分松解,置入假体试模后再次测量和检查髋周软组织的张力、关节活动和drop-kick试验,可以有效地治疗下肢的短缩。 相似文献
73.
L. Morino F. Bellomo P. Milano L. Bertignone M. Sabra 《Journal of orthopaedics and traumatology》2002,2(2):59-62
The authors, reviewing the international literature with their clinical experience developed in reconstructive surgery of
acetabular defects due to aseptic loosening of acetabular cups, suggest their guidelines to the right use of acetabular reinforcement
rings.
Received: 8 September 2001/Accepted: 4 November 2001 相似文献
74.
L. Molfetta A. Palermo G. De Caro F. Pipino 《Journal of orthopaedics and traumatology》2002,2(2):99-103
Thromboembolism constitutes one of the most dangerous complications during the immediate postoperative period of prosthetic
surgery. Pharmacological prophylaxis and mechanical vascular compression are not always sufficient to protect from this surgical
complication. In patients at greatest risk for thromboembolism, often with a positive history for pulmonary embolism, temporary
vena cava filters may be used to reduce the incidence of vascular and pulmonary complications. However useful, these filters
cannot be routinely used in orthopedic surgery. We present our results with the use of Filcard RFO2 vena cava filters in an
open, randomized study of 30 patients.
Received: 5 November 2001/Accepted: 30 November 2001 相似文献
75.
珊瑚型人工髋关节置换术的临床随访及松动原因的分析 总被引:5,自引:0,他引:5
自1983年至今应用珊瑚型人工髋关节置换术共54例60髋。其中人工全髋关节置换术34例40髋,人工股骨头置换术20例20髋。在54例60髋珊瑚型人工髋关节置换术中,有37髋随访6个月~13年,平均随访时间约7年,疗效满意率为85.1%,其中假体松动4例占14.8%,髋臼松动2例7.4%。假体松动原因是假体与股骨负重界面之间没有达到稳定接触,假体与髓腔形状不相匹配,修整髓腔松质骨时,髓腔扩大器应比假体小一号,避免假体与界面存留缝隙。对于髋臼发育不良的患者应避免髋关节旋转中心向外侧移位,应向内上方加深髋臼以减少水平移位距离,其次髋臼植骨加盖勿在负重区。 相似文献
76.
Hip arthroplasty is a common orthopaedic procedure with proven long-term success and reliable results. A wide range of associated conditions may affect the outcome of the arthroplasty and the surgeon has to keep these in mind when planning the surgery. In this article, such situations are discussed and recommendations are drawn from the evidence available in literature. 相似文献
77.
Abstract Closed suction drainage systems are commonly used in orthopaedic surgery, particularly in joint arthroplasty. The rationale
for the use of drains is a theoretical reduction of wound haematomas and infection. However the benefit of using drains after
total hip or knee arthroplasty is controversial. Several reports have shown that the use of drains does not reduce infection
and morbidity and is an unnecessary and potentially dangerous practice. In fact most studies highlighted that at best their
use appears to make no difference to important clinical outcomes. Recently a metaanalysis raised the question about the usefulness
of closed suction drainage again, concluding that it has no major benefits. The purpose of this study was to review the evidences
available concerning the utility of closed suction drainage outlining that this practice is not supported by clinical evidence. 相似文献
78.
The impact of total hip arthroplasty on psychological functioning was examined in 51 patients; 25 females and 26 males with a mean age of 65 years (range 42–81 years). Assessments of psychological well-being and distress were made with the Mental Health Inventory. Life satisfaction, self-rated health, and pain ratings were also obtained. Assessments were made prior to surgery, immediately after surgery, and at a 2 month follow-up. The operation produced significant improvements in psychological well-being (P < 0.001), psychological distress (P < 0.001). life satisfaction (P < 0.01), self-rated health (P < 0.001), and pain (P < 0.001). It is concluded that the changes in medical and functional status following hip arthroplasty documented in previous research are accompanied by substantial improvements in psychological state, and that the inclusion of psychological factors in hip arthroplasty research will provide a more comprehensive assessment of outcome. 相似文献
79.
Determination of bone mineral density by dual x-ray absorptiometry in patients with uncemented total hip arthroplasty. 总被引:9,自引:0,他引:9
Bone remodeling is an expected sequela with total hip arthroplasty (THA). Although there are several methods of estimating bone response in THA patients from radiographs, there are no accurate and generally accepted methods for quantitative determinations in vivo. In this study, we describe an application of dual x-ray absorptiometry (DXA) for measuring bone mineral content and bone mineral density in the proximal femur following THA. DXA is a noninvasive technique with minimal radiation exposure (< 5 mrem). Various aspects of measurement error (accuracy and reliability) of this application of DXA were determined in a series of studies reported here. Accuracy error (how similar are the measured and actual values) was < 1% determined in bone phantoms of four densities. Precision error (how reproducible are the measurements) was also < 1% at all four densities in the phantoms and was only slightly elevated (0.9-1.5%) in repeated measurements of implanted cadaver femora. Precision error in vivo, determined both from multiple replicates on five patients and from duplicate scans on 30 patients, was further elevated but remained < 5%. Contributions to precision error, rotation of the leg, and interoperator variability were assessed; none was found to elevate precision error appreciably. We suggest that DXA is a feasible method for quantifying bone response following THA, and will allow discrimination of small changes (> 5%) not previously measurable. 相似文献
80.
Manoj Todkar 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2006,16(2):1-4
We report outcome of 9-year follow-up of 50 Charnley cemented primary arthroplasties in 47 patients performed between 1996 and 1999. The minimum follow-up period was 5 years with a mean of 7 years. All hip joints were thoroughly assessed preoperatively to document patients’ functional level and Harris hip score was calculated. All the patients were disabled because of pain in hip and 45 (90%) had used walking aids. At follow-up all patients were living. The radiographs of all patients were available for the entire follow-up period. Of the 50 operated hips, only 2 patients (4%) complained of pain while all the rest were free of pain. Postoperatively only 10 (20%) patients used support for walking. At follow-up none of the hips were revised. Two patients (4%) had dislocation in postoperative period in which reduction was done under anesthesia. In one patient (2%) prosthesis and cement was removed because of deep infection. In two patients (4%) radiolucent clear zone was seen at bone cement interface on acetabular side and three (6%) patients had it on femoral component. None of the patients developed deep vein thrombosis or heterotopic bone. In postoperative period the Harris hip score was calculated in each case and compared with the preoperative score to evaluate the outcome. Significant improvement was found in Harris hip score after surgery. 相似文献