摘要
背景:得益于组织工程学的日益发展,过去由于疾病而被迫放弃自己肢体的患者,现在更多的可以选择保肢重建以挽救肢体功能。其中,人工全股骨置换在临床中的应用,就是组织工程学在保肢重建技术中的具体体现。目的:总结分析人工全股骨置换近年在保肢重建中的应用。方法:检索PubMed、知网等数据库,查阅与人工全股骨置换相关的文献,阅读全文,从手术适应证、手术治疗策略及术后常见并发症方面进行系统综述。结果与结论:①人工全股骨置换是一种适用于骨质状态差或存在严重骨缺损的重建技术,外形美观并保留了下肢功能,是一种优于传统保肢手术的重建手术;②手术适应证尚未达成共识,但通过文献检索发现多数学者认为肿瘤性疾病、反复发生的病理性骨折和困难翻修手术是该术式的主要手术指征;③髋关节不稳和感染是人工全股骨置换常见的并发症,糟糕的软组织条件是以上并发症发生的主要原因之一;④双/三动头联合外展肌群的重建可以有效预防髋关节不稳,延长抗生素的使用时间是目前防治人工全股骨置换后感染的主要手段,但效果不确切;⑤人工全股骨置换是近年来逐渐兴起的一种保肢重建技术,不同于毁损手术和传统的重建手术,它具有外形美观、保留下肢功能的优点;⑥目前人工全股骨置换的样本量较少、随访时间短,且相关病例报道相对孤立,尚无相关的大样本随机对照试验和荟萃分析,这给制定相应的共识和指南造成了一定的难度;⑦髋关节不稳和感染是手术失败的主要原因,该类患者糟糕的软组织条件常合并多种细菌定植,联合达托霉素治疗耐甲氧西林金黄色葡萄球菌的定植具有较好的疗效。
BACKGROUND:Attribute to the increasing development of tissue engineering,patients who were forced to abandon their limbs due to disease in the past are now more likely to choose limb salvage reconstruction to save limb function.Among them,the clinical application of total femoral arthroplasty is the specific embodiment of tissue engineering in limb salvage reconstruction technology.OBJECTIVE:To summarize and analyze the application methods of total femoral arthroplasty in limb salvage reconstruction in recent years.METHODS:The authoritative databases such as PubMed and CNKI were searched for the literature related to total femoral arthroplasty.After reading the full text,surgical indications,surgical treatment strategies,and common postoperative complications were systematically reviewed.RESULTS AND CONCLUSION:(1)Artificial total femoral arthroplasty is a reconstruction technique suitable for poor bone status or severe bone defect,with beautiful appearance and preservation of lower limb function.It is a reconstruction surgery superior to traditional limb salvage surgery.(2)There is no consensus on surgical indications,but most scholars believe that neoplastic diseases,recurrent pathological fractures and difficult revision surgery are the main surgical indications.(3)Hip instability and infection are common complications of total femoral arthroplasty,and poor soft tissue conditions are one of the main causes of the above complications.(4)Reconstruction of double/triple head combined with abductor muscle group can effectively prevent hip instability;prolonging the use time of antibiotics is currently the main means to prevent and treat postoperative infection after total femoral arthroplasty,but the effect is poor.(5)Total femoral arthroplasty is a limb salvage reconstruction technique that has gradually emerged in recent years.Unlike lesioning surgery and traditional reconstruction surgery,it has the advantages of beautiful appearance and preservation of lower limb function.(6)At present,the sample size of total
作者
曲兆鹏
荣杰生
Qu Zhaopeng;Rong Jiesheng(Second Ward of Orthopedic Surgery,Second Affiliated Hospital of Harbin Medical University,Harbin 150081,Heilongjiang Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第33期5374-5380,共7页
Chinese Journal of Tissue Engineering Research
关键词
骨
股骨
股骨假体
保肢
重建
肿瘤
适应证
翻修
综述
bone
femur
femur prosthesis
limb salvage
reconstruction
tumor
indications
revision
review
