简介:Abiomimetichipjointsimulatorthatcanbeusedtoevaluatetheoutcomeofthecementedtotalhipreplacementhasbeendesigned,manufacturedandevaluated.Thesimulatorproducesmotionintheextension/flexionplane,withasockettorotateinternal/externally.Atthesametimeadynamicloadingcycleisapplied.Avalidationtestwasperformedonacementedfemoralstemwithinanovelcompositefemur.Thebonequalityhasastrongeffectonthestemmigrationandontheintegrityoftheinterfaces.Themigrationofthestemisacombinationof3-Dtranslationandrotationofthestem.Underthesameloadingconditions,weakboneallowsmorestemmigrationthanstrongbone.Thereisagreatdecreaseinthestrengthofthestem-cementinterfaceafterthedynamictest,andtheweakbonecompositeexhibitedagreaterreductionininterfacialstrengththanthestrongbonecomposite.Thedecreaseoftheinterfacialstrengthindicatesthattheprimarybondingbetweenthestemandthecementmantlehaddeterioratedandtheintegrityofstem-cementinterfacewasdamaged.Thestudydemonstratesthevalueofusingahipjointsimulatortoinvestigatestemmigrationandinterfaceintegritywithinthecementedhipreplacement,suggestingthatmethodcanbeusedforinvitroevaluationofthebiomaterialsusedinthecementedhipreplacements.
简介:Objective:Toevaluatetheoutcomeoftotalhiparthroplasty(THA)withcementlesscupsandfemoralheadautograftsforpatientswithhipdysplasiaandosteoarthritis.Methods:Between1995and2002,weimplanted23cementlesscupsandfemoralheadautograftsin20patientswithhipdysplasiaandosteoarthritis.Inthisstudy,aretrospectivestudywasmadeon21hipsin20patients(18femalesand2males,aged50yearsonanaverage)withdevelopmentalhipdysplasiatreatedbyTHAwithacementlesscupandfemoralheadautograft.Theacetabularcupwasplacedatthelevelofthetrueacetabuinmandallthepatientsrequiredautogenousfemoralheadgraftsduetoacetabulardeficiency.Theaveragerateoftheacetabularcupcoveredbythefemoralheadautograftwas31%(rangingfrom10%to45%).Eighthipshadlessthan25%cupcoverageandthirteenbetween25%and50%.Theaveragefollow-upperiodwas4.7years(range,1-8years).ThereplacingoutcomewasevaluatedbymodifiedHarrishipscore.Preoperativeandfollow-upradiographsweremade.Results:Alltheautograftswereunitedtothehostbones.Noautograftwascollapsedornocomponentfromthehipwasloosedinallthepatients.AccordingtothemodifiedHarrishipscore,theaveragehipscoreincreasedfrom46beforeoperationto89atthefinalreview.Beforeoperation,theleg-lengthdiscrepancywasgreaterthan2cminallthepatientsexceptonewithbilateralhipdysplasia.Afteroperation,only2outof20patientshadaleg-lengthdiscrepancygreaterthan1cm.Threehipsshowedminorboneresorptioninthelateralportionofthegraft,whichdidnotsupportthecup.ThreehipsdevelopedGrade1BrookerheterotopicossificationandonedevelopedGrade2.Conclusions:THAwithacementlesscupandafemoralheadautograftforpatientswithosteoarthritisresultedfromhipdysplasiacanresultinfavorableoutcomes.Thismethodcanprovidereliableacetabularfixationandrestoretheacetabularbonestockinpatientswithdevelopmentalhipdysplasiawhenthe
简介:THEAPPLIEDSTUDYOFTHETOTALHIPREPLACEMENTFORTHEADULT'SCONGENITALDISLOCATIONOFTHEHIPATTHEPRIMARYACETABULUMTHEAPPLIEDSTUDYOFTHETO...
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简介:客观:为王牌探索起作用的指示和主要全部的新潮的关节造形术的起作用的方法平坦骨折并且观察临床的药品effect.Methods:我们回顾地总结了并且分析创伤的条件,破裂类型,复杂并发症,起作用的时间,起作用的技术,和11patients的短期的药品效果(10男性和1女性,与42的吝啬的年龄。4年)与王牌平坦骨折经历了主要全部的新潮的关节造形术。结果;病人被跟随在上面为6-45月(吝啬的=28月)。他们手术后的新潮的关节的普通哈里斯分数是78。结论:指示的Understrict控制,有平坦骨折可以经历的王牌的病人主要全部的新潮的关节造形术,而是稳定的王牌平坦部件应该被做。
简介:Objective:Toinvestigatetheinfluenceofhipandpelvicfracture,especiallyacetabularfracturecomplicatedbysciaticnerveinjuryonclinicalfeaturesandprognosisofsciaticnerveinjury.Methods:FromJanuary1987toJanuary2000,17patients(14maleand3female)whohadhipandpelvicfracturescomplicatedbysciaticnerveinjuryweretreatedwithoperativereductionandinternalfixationandfollowedupfrom10monthsto5years.Theaverageagewas38years(ranging23-56years).Theleftextremitieswereinvolvedin11patientsandtherightin6.Twelvepatientsunderwentprimaryexplorationandneurolysisand5patientsunderwentsecondaryoperation.Results:Preoperatively,8patientsweretreatedwithlargedosesoforalnarcoticstocontroltheirseveresciaticpain.Threeofthe8patientsunderwentpatient-controlledanalgesiaandepiduralanalgesia.Afteroperation,excellentandgoodratesofreductionandfunctionalrecoveryofsciaticnervewere94.1%and88%respectively.Fourpatientsstillhadsciaticpainand2patientsfailedtorecover.Sciaticnervefunctionimprovedwithin3-6monthsaftersurgeryin11patients.Conclusions:Hipandpelvicfracturescanresultinsciaticnerveinjury,especiallycommonperonealnerveinjuryandprognosisispoor.Openreductionandinternalfixationcombinedwithnerveexplorationandneurolysisshouldbeusedasearlyaspossibleforseveresciaticpain.
简介:Objective:tostudytheclinicalinfluenceoffemoralqualityoncementlesshipreplacementandtoevaluatecorticalindex(CI)forfemoralqualityinordertoguideprosthesischoiceandrehabilitation.Methods:forth-ninecasesofcementlesshipreplacementwerefollowedupforaverage3.5years,42ofwhonhadX-rayfilmsonpreoperationoroperationday.Results:Harrisscoresandpatients'satisfactionwerelowbutpainwassignificantandprolongedwhencorticalindiceswerelow.Conclusions:CIisareliablesemi-quantityparameterforclinicalevaluationoffemoralquality.Osteoporosispatientspredisposetothighpain.Lagforfull-weightloadingandavoidancefortorsionmotioncancontributetolesspainwhenCI≤2.2.
简介:客观:为了在臀部以后学习大腿骨的新潮的修复术的压力分发,连接代替。方法:在新潮的联合代替以后,腿节和修复术什么时候完美地被认为柱体同样同心与banded接口,模仿界面的压力转移的一个相对完美的理论模型被建立。结果:最大值界面砍应力发生在Z=0。在大腿骨的颈的剖面图,界面砍应力随Z的增加指数地减少了。砍应力在Z0.1m变得很小,它意味着在大腿骨的新潮的修复术的远目的shear压力是很小的。为了避免压力集中和大腿骨的新潮的修复术,下沉、界面的应力必须在Z=0仍然保持与压力负担不变、平衡。大腿骨的新潮的修复术的半径随着变化了界面砍应力。半径的最大的价值发生在Z=0,然后,它在m减少了。特殊,在Z=10公里的a=18.2公里,在Z=98公里的a=5.36公里,这些是理想的半径。结论:模仿界面的压力的一个理论模型被证实腿节和修复术是否被认为柱体同样同心。分布界面砍并且有轴的位置的光线的压力被获得。为修复术的设计的一本理论参考书被提供。
简介:作者报导了支撑了臀部的无法缩减的postero侧面的创伤的脱臼与的一个27岁的人的案例胶囊并且labral陷阱。起始的X光显示出仅仅小acetabular碎片。在在一般麻醉下面与肌肉麻痹减少臀部的二次尝试失败了以后,病人被立即的开的减小通过一条postero侧面的途径对待。臀部的外科的探索表明小osteochondral碎片属于上唇和囊的一大片,堵塞髋臼。大腿骨的头与扭扣孔效果在撕的囊上交叉。这些元素被减轻,骨头碎片与2公里螺丝钉被修理,囊被修理。在10年的后续,功能的结果与100个点的一个哈里斯分数和坏死或骨关节炎的没有迹象是优秀的。作者建议这不平常的损害的文学评论。