Việc loại bỏ cấy ghép cố định vững chắc TRONG arthroplasty sửa đổi hông và đầu gối là một thủ tục kỹ thuật đầy thử thách với tiềm năng cho một số tiền lớn mất xương TRONG loại bỏ thành phần. Điều này mất xương bị tổn thương tái thiết tháng tiếp theo. Lập kế hoạch cẩn thận trước phẫu thuật cần thiết IS | Removal of Solidly Fixed Implants During Revision Hip and Knee Arthroplasty Bassam A. Masri MD FRCSC Philip A. Mitchell FRCS Tr Orth and Clive P. Duncan MD FRCSC Abstract The removal of solidly fixed implants during revision hip and knee arthroplasty is a technically challenging procedure with the potential for a large amount of bone loss during component removal. This bone loss may compromise the subsequent reconstruction. Careful preoperative planning is essential before undertaking removal of solidly fixed implants. The surgeon should determine the type and size of the implants and be familiar with any specialized removal equipment that may be available. For both the hip and knee extensive exposure is often necessary. Removal of a well-fixed femoral component often requires an extended trochanteric osteotomy. The most difficult component to remove from the knee is a well-fixed cementless patellar component. The primary goal in removing well-fixed components is to minimize loss of surrounding bone which requires effective planning and often access to specialized tools and techniques. J Am Acad Orthop Surg 2005 13 18-27 The success of revision surgery depends in large part on the quality of host bone remaining after implant removal. When revising loose components iatrogenic damage to the host bone can be kept to a minimum with careful technique however with solidly fixed components avoiding further damage is more challenging. Success in this area of revision arthroplasty surgery requires a thorough understanding of the indications for removal of solidly fixed components sound preoperative planning selection of the appropriate surgical approach and knowledge of the techniques available to remove these implants. The Hip Not all mechanisms of failure in total hip arthroplasty require revision of solidly fixed implants. For example excessive polyethylene wear in a modular cementless acetabular component with satisfactory position and locking mechanism can be managed .
