中国组织工程研究

中国组织工程研究 ›› 2021, Vol. 25 ›› Issue (27): 4318-4321.doi: 10.12307/2021.189

• 人工假体 artificial prosthesis • 上一篇    下一篇

股骨假体无菌性松动翻修中应用的 SLR-PLUS生物型加长矩形柄

陆逸卿，何  斌，王伯尧，秦  虎，范  磊，王云华   

  1. 南京医科大学第二附属医院骨科，江苏省南京市   210011
  • 收稿日期:2020-10-13 修回日期:2020-10-14 接受日期:2020-12-07 出版日期:2021-09-28 发布日期:2021-04-10
  • 通讯作者: 范磊，博士，副主任医师，南京医科大学第二附属医院骨科，江苏省南京市 210011 王云华，主任医师，南京医科大学第二附属医院骨科，江苏省南京市 210011
  • 作者简介:陆逸卿，男，1994年生，江苏省昆山市人，汉族，南京医科大学在读硕士，主要从事关节和创伤研究。
  • 基金资助:
    2017 年江苏省级自然科学基金(青年科技人才专项基金)(BK20171092)，项目负责人：范磊

Application of SLR-PLUS biological lengthened revision stem in the revision of aseptic loosening of femoral prosthesis

Lu Yiqing, He Bin, Wang Boyao, Qin Hu, Fan Lei, Wang Yunhua   

  1. Department of Orthopedics, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
  • Received:2020-10-13 Revised:2020-10-14 Accepted:2020-12-07 Online:2021-09-28 Published:2021-04-10
  • Contact: Fan Lei, MD, Associate chief physician, Department of Orthopedics, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China Wang Yunhua, Chief physician, Department of Orthopedics, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
  • About author:Lu Yiqing, Master candidate, Department of Orthopedics, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
  • Supported by:
    the Natural Science Foundation of jiangsu in 2017, No. BK20171092 (to FL)

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摘要：

文题释义：
股骨假体无菌性松动：是髋关节置换术后失败的主要原因之一，松动原因比较复杂，目前认为患肢的骨溶解是主要因素，早期股骨假体的松动骨溶解机制为应力遮挡引起的骨质重新塑形导致，晚期假体骨溶解主要是假体的微动及磨损颗粒导致的。股骨侧假体无菌性松动会导致股骨侧骨缺损、假体下沉微动，引起患者疼痛不适，行走困难，进而需要进行翻修手术。
翻修：是各种原因导致髋关节置换术后失败后的一种手术治疗，具有手术难度大、持续时间长、出血量大、感染风险高等特点。髋关节翻修需要有在完善的术前评估下同时明确手术适应证，另外，选择合适的翻修假体及手术方式是恢复患者良好关节功能的条件。

背景：髋关节翻修是各种原因导致髋关节置换失败的一种手术治疗，选取合适的翻修假体及手术方式是恢复患者良好关节功能的条件。
目的：探讨SLR-PLUS生物型加长矩形柄在股骨假体无菌性松动翻修中的临床疗效。
方法：纳入2017年6月至2018年12月南京医科大学第二附属医院收治的行髋关节翻修患者16例，返修原因为股骨侧假体无菌性松动，其中男7例，女9例，年龄63-82岁。均进行SLR-PLUS生物型加长矩形柄翻修手术，术后进行影像学评估和髋关节功能评估。所有患者对治疗方案均知情同意，试验得到南京医科大学第二附属医院-伦理委员会批准。
结果与结论：①16例患者均顺利完成手术，未出现髋关节感染、脱位及双下肢深静脉血栓形成等相关并发症；术后所有患者血沉和C-反应蛋白均降至正常水平，无感染迹象；术后获得6-30个月随访；②术后12周时及末次随访影像学检查显示，假体位置良好，均未出现假体周围新的透亮带，股骨假体与周围骨质匹配良好；③16例患者术后12周的髋关节功能Harris评分高于术前(P < 0.05)，其中优良率达到94%；④结果表明，应用SLR-PLUS生物型加长矩形柄翻修治疗髋关节股骨侧假体无菌性松动具有良好的即刻稳定性及中期稳定性，疗效满意。
https://orcid.org/0000-0001-6931-4751 (陆逸卿) 

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 骨, 假体, SLR-PLUS, 加长柄, 髋关节置换, 无菌性松动, 翻修

Abstract: BACKGROUND: Revision hip joint is a kind of surgical treatment that causes failure of hip joint replacement for various reasons. Selecting appropriate revision prosthesis and surgical method are the conditions to restore good joint function of patients.  
OBJECTIVE: To investigate the clinical effect of SLR-PLUS biotype extended rectangular stalk in the revision of femoral prosthesis with aseptic loosening.
METHODS:  Sixteen patients undergoing revision of the hip joint admitted to the Second Affiliated Hospital of Nanjing Medical University from June 2017 to December 2018 were included. The reason for the revision was aseptic loosening of the femoral side prosthesis, including 7 males and 9 females, aged 63-82 years. All patients underwent SLR-PLUS biologic long rectangular handle revision surgery, and imaging assessment and hip function assessment were performed postoperatively. All patients gave informed consent to the treatment plan. The trial was approved by the Ethics Committee of the Second Affiliated Hospital of Nanjing Medical University.  
RESULTS AND CONCLUSION: (1) All the 16 patients successfully completed the operation without complications such as hip joint infection, dislocation and deep venous thrombosis of lower limbs. After the operation, all patients’ blood sedimentation and C-reactive protein levels were reduced to normal levels without signs of infection. The patients were followed up for 6-30 months after operation. (2) The imaging examination at 12 weeks after the operation and the last follow-up showed that the prosthesis was in good position; no new transparent belt appeared around the prosthesis; and the femoral prosthesis was well matched with the surrounding bone. (3) Harris score of hip joint function 12 weeks after operation was higher than that before operation in 16 patients (P < 0.05), and the excellent and good rate reached 94%. (4) The results showed that SLR-PLUS biotype extended rectangular handle revision treatment for femoral side prosthesis aseptic loosening of hip joint has good immediate stability and medium-term stability, and the curative effect is satisfactory.

Key words: bone, prosthesis, SLR-PLUS, lengthened revision stem, hip replacement, aseptic loosening, revision

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