在全髋关节置换术中先行股骨头截骨,并在无法截骨的情况下组装 MUTARS® 装置。

Hip & pelvis Pub Date : 2023-12-01 Epub Date: 2023-12-04 DOI:10.5371/hp.2023.35.4.277
Jee Young Lee, Ye Jun Lee, Gyu Min Kong
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引用次数: 0

摘要

全髋关节置换术后脱位发生率约为 1%,但翻修手术后的发生率要高得多。为防止脱位,建议使用较大的股骨头,并引入了双活动股骨头。然而,在关节周围软组织挛缩的病例中,将双活动股骨头缩小至髋臼组件是很困难的。一位72岁的男性患者因假体周围关节感染而接受了两阶段的MUTARS®翻修手术。翻修手术两个月后,髋关节脱位,尝试了人工复位,但脱位再次发生。在另一次使用双活动轴承进行翻修时,髋关节周围的软组织太紧,无法缩小。为了解决这个问题,首先将双活动度轴承头重新定位到髋臼窝中,然后组装植入物的骺端部分。
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Reduction of the Femoral Head First, and Assembly of the MUTARS® Device in Case of Impossible Reduction during Total Hip Arthroplasty.

Dislocation after a total hip arthroplasty occurs in approximately 1% of patients; however, the frequency is much higher after revision surgery. To prevent dislocation, use of a larger femoral head is recommended, and a dual mobility femoral head has been introduced. However, reducing the dual mobility femoral head to the acetabular component is difficult in cases involving contracture in the soft tissue around the joint. A 72-year-old male patient who developed a periprosthetic joint infection underwent two-stage revision surgery using MUTARS®. Two months after the revision, the hip joint became dislocated and manual reduction was attempted; however, dislocation occurred again. During another revision using a dual mobility bearing, the soft tissue around the hip joint was too tight to reduce. The problem was overcome by first repositioning the dual mobility head into the acetabular socket, followed by assembly of the diaphyseal portion of the implant.

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