髋臼高位放置技术在人工髋关节置换中的应用研究与进展

发布时间：2018-04-24 00:31

本文选题：关节成形术 + 置换　；参考：《中国组织工程研究》2017年11期

【摘要】：背景:先天性髋臼发育不良患者与髋关节翻修患者常存在髋臼上方骨量缺损,使得髋臼侧的处理在髋关节置换术中更为复杂困难。有学者建议髋臼高位放置确保适当的宿主骨接触的同时简化手术,而其作为影响生物力学的手术方式引起很多人的担忧,甚至临床疗效遭到质疑。目的:综述近年国内外髋臼高位放置技术在人工髋关节置换术中的研究进展。方法:第一作者应用计算机检索至2016年12月Pub Med数据库、相关期刊论文的相关文章,以"proximal placement,superior placement,high placement,high hip center,elevated hip center,total hip arthroplasty,revision total hip arthroplasty,dysplasia of developmental hip"为英文检索词,"高旋转中心,髋臼高位技术,髋臼高位放置,全髋关节置换术,髋关节翻修术,先天性髋关节发育不良"为中文检索词。共检索到67篇相关文献,45篇文献符合纳入标准。结果与结论:(1)对于髋关节置换手术中面临的髋臼骨缺损问题,髋臼高位放置是一种选择,尤其对复杂骨缺损患者可以简化手术;(2)尽管违背了恢复解剖旋转中心的原则,通过重建位置的调整、摩擦界面的改善、假体的适当选择,以及手术技术和理念的进步,髋臼高位技术可以在与宿主骨直接接触的范围和强度的基础上获得良好的初始稳定性,进而实现令人满意的长期生物固定效果,同时不会影响髋关节的生物力学;(3)目前中英文文献中髋臼高位放置的定义和名称较为混乱,有待对此进一步规范完善。
[Abstract]:Background: congenital acetabular dysplasia and hip revision patients often have superior acetabular bone defect, which makes the management of acetabular side more difficult in hip arthroplasty. Some scholars suggest that high acetabular placement should ensure proper contact with host bone and simplify the operation. However, as a biomechanical method, it has caused many people to worry, and even the clinical efficacy has been questioned. Objective: to review the research progress of high acetabular placement in hip arthroplasty in recent years. Methods: the first author searched the Pub Med database by computer until December 2016 and related articles in the full text database of Chinese periodicals. The key words were "proximal placement superior placementor high placementor high hip center elevated hip center total hip arthroplast total hip severe developmental hip", "High rotation center, high acetabular position technique". High acetabular placement, total hip replacement, hip revision, congenital hip dysplasia are Chinese key words. A total of 67 related articles were retrieved and 45 articles met the inclusion criteria. Results and conclusion: for acetabular defects in hip arthroplasty, high acetabular placement is an option, especially in patients with complex bone defects, although it is a violation of the principle of restoring anatomical centers of rotation. With the adjustment of the reconstruction position, the improvement of the friction interface, the proper selection of the prosthesis, and the progress of surgical techniques and concepts, the acetabular high position technique can obtain good initial stability based on the range and strength of direct contact with the host bone. So as to achieve a satisfactory long-term biomechanical fixation effect without affecting hip biomechanics. (3) the definition and name of acetabular high placement in Chinese and English literature are confused and need to be further standardized and perfected.
【作者单位】：解放军总医院骨科;
【基金】：北京市自然科学基金(7152139)~~
【分类号】：R687.4

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