髋关节骨质疏松患者的全髋关节置换术:综述。

Mohammad Daher, Elio Mekhael, Mouhanad M El-Othmani
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引用次数: 0

摘要

骨质疏松和骨质减少可影响髋关节置换术患者,这通常推荐给患有严重骨关节炎的患者或老年股骨颈骨折患者。术前筛查这种类型的骨质流失可能有助于患者,并防止因骨质疏松症的漏诊率而导致的不良结果,在接受髋关节置换术的患者中,骨质疏松症的漏诊率可达73%。与低骨密度相关的并发症包括假体周围骨折以及翻修率增加。虽然术后抗吸收药物的益处已被证实,但术前给予抗吸收药物的结果比未使用更差。手术治疗和药物治疗同样重要。根据一般建议,骨水泥种植体对骨质疏松患者有更大的益处。然而,当使用无骨水泥种植体时,肋状茎、直锥形茎、与内侧跟骨接触的茎和钛成分茎可用于防止假体周围骨矿物质密度的损失;然而,它们不应该被放置在内翻的位置。这些茎也可以涂上唑来膦酸盐和其他产品。
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Total Hip Arthroplasty in Patients with Hip Osteoporosis: A Narrative Review.

Osteoporosis and osteopenia can affect patients undergoing arthroplasty of the hip, which is typically recommended for patients with severe osteoarthritis or elderly patients with a femoral neck fracture. Preoperative screening for this type of bone loss could be helpful to patients and prevent poor outcomes due to the rate of underdiagnosis of osteoporosis, which can reach 73% in patients undergoing hip arthroplasty. Complications associated with low bone mineral density include periprosthetic fractures as well as an increased revision rate. Although the benefit of antiresorptive medications postoperatively has been demonstrated, when administered preoperatively, worse outcomes were reported compared to its non-usage. Surgical management is as important as pre-medication. According to general recommendations, cemented implants provide greater benefit in osteoporotic patients. However, when using cementless implants, ribbed stems, straight tapered stems, stems with medial calcar contact, and titanium-composed stems can be used to prevent periprosthetic loss of bone mineral density; however, they should not be placed in a varus position. These stems can also be coated with zoledronate and other products.

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Bibliometric Analysis of Dual Mobility Total Hip Arthroplasty. Finite Element Analysis of a New Acetabular Plate in the Combined Posterior Column and Posterior Acetabular Wall Fracture Model. Intravenous Injection of Tranexamic Acid in Patients with Pelvic Fractures: A Prospective Randomized Trial. Evaluation of the Influence of Changes in Bone Mineral Density and Increases in Articular Cartilage Thickness on Blood Supply of the Femoral Head in Legg-Calvé-Perthes Disease. Modified Transiliac Plating Technique for Complex Posterior Pelvic Ring Injuries.
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