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báo cáo hóa học:" A technique to remove a well-fixed titanium-coated rm acetabular cup in revision hip arthroplasty"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí sinh học quốc tế đề tài : A technique to remove a well-fixed titanium-coated rm acetabular cup in revision hip arthroplasty | Judas et al. Journal of Orthopaedic Surgery and Research 2011 6 31 http www.josr-online.eom content 6 1 31 JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH TECHNICAL NOTE Open Access A technique to remove a well-fixed titanium-coated rm acetabular cup in revision hip arthroplasty Fernando MJ Judas Rui F Dias and Francisco M Lucas Abstract A major concern during revision hip arthroplasty is acetabular bone loss and bleeding during the extraction of well-fixed cementless acetabular cup because no interface exists between the host bone and the cup. Forceful removal of such component using curved gouges and osteotomes often leads to extended bone loss and compromises reimplantation of a new socket. In the following case report we removed a well-fixed polyethylene titanium-coated RM acetabular cup with 20 years of follow-up by significant wear of the polyethylene layer. The isoelastic femoral stem was also removed by mechanical failure. We report a technique for removal of the cementless acetabular cup using powered acetabular reamers. The RM cup was sequentially reamed and when the polyethylene layer was thin enough the remaining cup was removed easily by hand tools. The acetabular bone stock is preserved and the risks of bone fractures and bleeding are minimized. To our knowledge these principles were applied only in cemented cups. We have used this technique in 10 cases with excellent results and no complications were noted. This is a simple reproducible non-costly non-timing consuming safe and successful technique to remove well-fixed titanium-coated RM acetabular cups. Introduction The purpose of revision hip arthroplasty is to reconstruct the hip to reproduce as closely as possible the form and function of the native joint. The indications for revision include significant polyethylene wear fractures of the components component malposition hip instability severe thigh pain excessive damage to the femoral Morse taper and severe infection 1-3 . In revision hip surgery the