کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4080772 1267566 2016 11 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Removal of well-fixed fixed femoral stems
ترجمه فارسی عنوان
حذف ساقه های ثابت فمورال ثابت
کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی ارتوپدی، پزشکی ورزشی و توانبخشی
چکیده انگلیسی

The removal of a well-fixed prosthetic stem raises technical challenges. The objective is not only to remove the material, but also to prepare the implantation of a new prosthesis. Cemented stems are only very rarely unremovable; extraction of the cement mantle and plug raises the greatest difficulties. The main risk is cortex perforation, and a radiograph should be obtained at the slightest doubt. The removal of cementless stems carries a higher risk of fracture. Difficulties should be anticipated based on thorough familiarity with the implant design and on evaluations of implant fixation and bone stock. The intramedullary approach is usually sufficient to extract a cemented or cementless, well fixed, standard stem. Routine use of a transfemoral approach is warranted only in the following situations: revision surgery for infection, S-shaped stem, long stem, curvature or angulation of the femoral shaft, or unfeasible hip dislocation. However, the possibility that the intramedullary approach may need to be converted to a transfemoral approach should be anticipated. Thus, preoperative planning must include determination of the optimal length of a femoral osteotomy or femoral flap, should one be needed, and the surgeon must have access to all the revision implants and tools that might be needed for re-implantation. Experience with the various techniques is indispensable, as a well-performed extensive approach is associated with less morbidity than a fracture or trajectory error. There are three main techniques, which are described here: intramedullary extraction of a cementless stem, intramedullary extraction of a cemented stem, and transfemoral extraction through an extended trochanterotomy. The patients should receive detailed information on the difficulties of femoral stem removal and on the available solutions.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Orthopaedics & Traumatology: Surgery & Research - Volume 102, Issue 1, Supplement, February 2016, Pages S177–S187
نویسندگان
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