Revision surgery in total hip arthroplasty
著者
書誌事項
Revision surgery in total hip arthroplasty
Springer-Verlag, c1990
- : us
- : gw
並立書誌 全1件
大学図書館所蔵 全4件
  青森
  岩手
  宮城
  秋田
  山形
  福島
  茨城
  栃木
  群馬
  埼玉
  千葉
  東京
  神奈川
  新潟
  富山
  石川
  福井
  山梨
  長野
  岐阜
  静岡
  愛知
  三重
  滋賀
  京都
  大阪
  兵庫
  奈良
  和歌山
  鳥取
  島根
  岡山
  広島
  山口
  徳島
  香川
  愛媛
  高知
  福岡
  佐賀
  長崎
  熊本
  大分
  宮崎
  鹿児島
  沖縄
  韓国
  中国
  タイ
  イギリス
  ドイツ
  スイス
  フランス
  ベルギー
  オランダ
  スウェーデン
  ノルウェー
  アメリカ
注記
Includes bibliographical references and index
内容説明・目次
内容説明
Revision surgery. A practical approach to problems and com- plications of total hip arthroplasty. Based on the study of long term results and operative techniques evolved over 20 years experience in this field of work.
目次
1 Introduction.- Section I: Complications Leading to Revision Surgery.- 2 Haematoma.- The Role of Anaesthesia.- Classification of Haematoma.- Superficial Haematoma.- Deep Haematoma.- Infected Haematoma.- 3 Problems Arising from an Inadequate Exposure.- What is Required at the Time of the Exposure?.- Exposure of the Acetabulum.- Exposure of the Medullary Canal.- Preservation of the Integrity of the Abductors.- 4 Trochanteric Osteotomy and Problems Resulting from It.- Trochanteric Osteotomy.- Problems Related to Trochanteric Osteotomy.- Increased Blood Loss and Operating Time.- Trochanteric Bursitis (or Trochanteric Pain).- Trochanteric Non-union.- Pain.- Limp.- Dislocation.- 5 Dislocation.- The Mechanism of Dislocation.- Impingement.- Distraction.- Dislocation Following Primary Surgery.- Loss of the Abductor Mechanism.- Shortening of the Limb.- Malorientation of the Components.- Practical Approach to Dislocation: Non-operative Methods.- Operative Procedures.- Recent Advances.- 6 Infection.- Incidence of Deep Infection.- The Size of the Sample Studied.- The Length of the Follow-up.- Deep Sepsis in Osteoarthritis.- Deep Sepsis in Rheumatoid Arthritis.- Deep Sepsis Following Previous Hip Surgery.- Patients at Risk for Deep Sepsis.- Males with Post-operative Urinary Retention, Catheterization and Prostatectomy.- Diabetics.- Patients with Psoriasis.- Prevention of Deep Infection.- Review of the Use of ALAC in Total Hip Arthroplasty.- Leaching out from Acrylic Bone Cement.- Revisions for Deep Sepsis Using Plain Acrylic Cement.- Revisions for Deep Sepsis Using ALAC (Palacos plus 0.5 g Gentamicin).- Release of Gentamicin from Acrylic Cement: Ex Vivo Study.- Comparison of Plain CMW Acrylic Cement and ALAC (Palacos plus 0.5 g Gentamicin).- Diagnosis of Deep Infection.- Classification of Infection.- Late Infection.- Management of Deep Infection.- Conservative.- Operative - One- or Two-Stage Revision?.- The Principles of One-Stage Revision for Deep Infection.- Results of Revisions for Deep Infection.- The Use of Antibiotic-Loaded Acrylic Beads.- The Concept.- Clinical Use.- 7 Loosening of the Components.- What is Required for Component Fixation?.- Containment and Pressurization of Cement.- Socket Fixation.- The Femur.- 8 The Socket: Changes at the Bone-Cement Interface.- Demarcation of the Socket.- Socket Migration.- Correlation Between Radiographic Appearances and the Clinical Results.- Correlation Between Radiographic Appearances and the Operative Findings.- Correlation Between the Depth of Socket Wear and the Incidence of Socket Migration.- Correlation Between Radiographic Appearances and Long-Term Clinical Results.- Socket Demarcation and Loosening.- Surgical Technique.- Socket Wear.- Natural History of the Hip Condition.- 9 Loosening of the Socket.- The Time Lag Between Primary and Revision Surgery.- The Correlation Between the Clinical, the Radiological and the Operative Findings.- Wear of the Socket: The Mechanical and Histological Changes Resulting from It.- 10 Wear of the Socket.- Radiographic Measurement of Socket Wear.- Wear Measurement of Explanted Sockets.- Correlation Between Real and Radiographic Wear Measurements.- Direction of Wear.- Impingement.- The Effect of Cement Ingress into the Socket.- Reduced Diameter Neck Stem.- Mechanical Testing of the Reduced Neck Stem.- Summary.- 11 Tissue Reaction to High-Density Polyethylene Wear Particles.- Teflon.- High-Density Polyethylene.- 12 Metal Backing of the Socket.- 13 Loosening of the Stem.- Intramedullary Bone Block.- The Pacheco Study.- Unchanged Radiographic Appearances.- Demarcation of Distal Femoral Cement.- Separation of the Stem from Cement.- Fracture of the Femoral Cement at the Tip of the Stem.- Endosteal Cavitation of the Femoral Cortex.- Position of the Stem Within the Medullary Canal.- Previous Hip Surgery.- Primary to Revision Surgery.- Radiological Appearances of Failure of Stem Fixation.- Patterns of Failure of Stem Fixation.- Slip of the Stem Within the Cement Mantle.- Slip of the Stem-Cement Complex Within the Medullary Canal.- Tilt of the Stem.- Tilt of the Stem-Cement Complex.- Pivoting of the Implant Within the Cement.- Pivoting of the Implant Within the Bone.- Pivoting of the Stem-Cement Complex.- The Sequelae of Failure of Stem Fixation.- Lack or Loss of Proximal Support in the Presence of Good Distal Fixation.- Endosteal Cavitation.- 14 Fracture of the Stem.- Patients? Function.- Patients? Weight and Time to Fracture.- Surgical Technique.- Radiographic Appearances.- Fracture of the Femoral Cement.- Endosteal Cavitation of the Femur.- Early Radiographic Signs of Failure of Stem Fixation.- Position of the Stem Within the Medullary Canal.- Comparison of Cases from Two Sources.- The Mechanism of Fracture of the Stem in Total Hip Arthroplasty.- Obliquity of the Fracture.- Bending of the Proximal Fragment.- Fracture Wave.- Fracture Lip.- The Level of Fracture of the Stem.- Fracture of the Stem Following Revision Surgery.- The Pattern.- The Specimens.- Radiographs.- Mechanism of Stem Fracture.- Experimental Confirmation.- Clinical Implications.- Recent Developments.- Fracture of the Stem in the Uncemented Metal-to-Metal Arthroplasty.- 15 Fracture of the Shaft of the Femur.- 16 Heterotopic Ossification.- Proposed Definition.- The Incidence.- The Site.- The Extent.- Inclusion of Cancellous Bone in the Operative Site.- Periosteal Stripping.- Excision.- Section II: Practical Approach to Revision Surgery.- 17 Timing of Revision Surgery.- Problems to be Anticipated at Follow-up.- Deep Infection.- Dislocation.- Fracture of the Stem.- Loosening of the Stem.- Loosening of the Socket.- Correlation Between Radiological Appearances and Clinical Function.- 18 Assessment of the Patient.- Assessment of the Arthritic Hip.- Assessment of a Patient with Failed Total Hip Arthroplasty.- Clinical History.- Pain in Failed Total Hip Arthroplasty.- Function..- Straight Leg Raising.- Local Examination.- Special Investigations.- Discussion with the Patient.- Anaesthetic Assessment.- 19 Instrumentation for Revision Surgery.- The Diagnosis.- The Availability of the Instruments and the Components.- Removal of Trochanteric Wires.- Trochanteric Osteotomy.- Mobilization of the Proximal Femur and Dislocation.- Extraction of the Femoral Stem.- Socket Exposure, Testing and Extraction.- Removal of the Femoral Cement.- Removal of the Distal Cement Plug.- Extraction of the Complete Cement Mantle from the Medullary Canal.- Extraction of the Distal Fragment of Fractured Stem.- 20 Selection of Components.- The Acetabulum.- The Femur.- 21 Revision Surgery: The Technique.- Positioning the Patient.- The Incision.- Incision in the Deep Fascia.- The Landmarks.- Removal of the Trochanteric Wires.- The Claw Hammer Method.- The Sardine-Can Method.- Exposure of the Hip Joint.- Trochanteric Osteotomy.- Examination of the Components.- Exposure and Examination of the Acetabular Cavity.- Preparation of the Acetabulum and Fixation of the Socket.- 22 Revision with Trochanteric Non-union: Reattachment of the Un-united Trochanter.- The Series.- 23 The Femur.- Extraction of the Femoral Component.- Removal of the Acrylic Cement.- The Proximal Part.- The Middle Part.- The Distal Part.- Femoral Cement Restrictors.- Removal of Fibrous or Pyogenic Granulation Tissue from the Bone-Cement Junction.- Removal of a Thin Layer of Condensed Cancellous Bone.- Excavation of the Lesser Trochanter.- Selection of a Femoral Stem and Trial Reduction.- Trial Reduction.- Distal Closure of the Medullary Canal and Stem Insertion.- Reattachment of the Greater Trochanter.- Reattachment of the Greater Trochanter when the Stem has not Been Changed.- 24 Loss of Bone Stock.- Acetabular Defects.- Central Acetabular Deficiencies.- Superior Acetabular Defects.- Disruption of the Acetabular Rim.- Support and Reinforcement Rings.- Future Developments.- Femoral Defects.- Minor Femoral Deficiencies.- Major Deficiencies of the Proximal Femur.- Practical Approach: The Modular Stem System.- Future Developments.- 25 Wound Closure.- The Acetabulum, Femur and Total Hip Components.- The Capsule, the Abductors, the Greater Trochanter and the Vastus Group of Muscles.- The Deep Fascia.- Subcutaneous Fat.- The Skin.- The Use of Drains.- 26 Post-operative Management.- Section III: The Ultimate Challenge of Surgery.- 27 Girdlestone Pseudarthrosis for a Failed Total Hip Arthroplasty.- Indications for Pseudarthrosis.- The Operative Procedure.- Post-operative Management.- Clinical Results.- Conclusion.- 28 Pulmonary Embolism.- Prediction.- Prevention.- Treatment.- Reviews of Pulmonary Emboli Trends.- Yearly Variations in Incidence.- Seasonal Variations in Incidence.- Variations in the Incidence Between Different Patient Groups.- The Incidence of Fatal Pulmonary Emboli During the Post-operative Period.- Mortality Due to Causes Other than Pulmonary Embolism.- Section IV: Conclusions.- 29 Conclusions.- References.
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