トータルヒップ関節整形手術の生存に影響を与える危険因子として,骨の質が悪かったり,股関節構造が悪かったり
S Kobayashi1, N Saito, H Horiuchi
1Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan. seneki@hsp.md.shinshu-u.ac.jp
Lancet (London, England)
|May 9, 2000
まとめ
トータルヒップ関節整形術 (THA) のアセプティック固定不全は,骨の質と構造の不良に関連しています. 縮性骨格関節症や不利な運河幾何学などのこれらの危険因子を特定することは,THAの耐久性を改善するために非常に重要です.
科学分野:
- 整形外科の手術は,整形外科の手術です.
- バイオマテリアル科学 バイオマテリアル科学
- 医療エンジニアリング 医療エンジニアリング
背景:
- アセプティック固定不全は,総股関節整形手術 (THA) の後の主要な長期的な合併症です.
- 既存の義肢と技術は,骨の質が悪いことや,股関節の構造に不十分に対応しています.
- この研究では,THA.の無菌固定不全に寄与する危険因子を調査しています.
研究 の 目的:
- トータルヒップ関節整形手術後のアセプティック固定不全に関連した特定の危険因子を特定する.
- ソケットの緩解と股関節固定不全に寄与する要因を分析する.
- THAにおけるポリエチレンの急速な磨損の発展を調査する.
主な方法:
- 405件のプライマリチャーンリー整骨関節整形手術の多変量分析.
- 生存率の評価とアセプティック固定障害の危険因子の特定.
- ポリエチレンの急速な磨損 (浸透深さ > または = 2 mm/年) の危険因子の調査.
主要な成果:
- 軟骨関節症とポリエチレンの急速な磨損は,ソケットの緩解の危険因子です.
- 不良な髄膜運河幾何学 (ストーブパイプ運河) は,股関節固定不全の危険因子である.
- Ortron 90の股関節義肢は,ポリエチレンの急速な磨損率を大幅に低下させました.
結論:
- 骨の質の悪さ (軟骨性関節症) は,THA.におけるソケット生存に影響する.
- 骨の構造が悪い (運河の幾何学が良くない) は,股関節義肢の生存に影響する.
- THAの長寿を高めるために,これらの要因のさらなる評価と生物学的介入が必要である.
関連する概念動画
01:27Fractures: Bone Repair
Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
01:29Bone Disorders
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:09Changes in the Appendicular Skeleton with Age
The upper and lower limb initially develops as a small bulge called a limb bud, which appears on the lateral side of the early embryo. The upper limb bud appears near the end of the fourth week of development, with the lower limb bud appearing shortly after.
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
01:24Healing II: Complications
Complications during healing arise when tissue repair is altered by local or systemic factors. These changes involve abnormal collagen deposition, altered biomechanics, and reduced vascular supply, impairing restoration of normal structure and function.Loss of FunctionScar tissue differs significantly from the original tissue it replaces. In the skin, fibrosis lacks adnexal structures such as hair follicles, sebaceous glands, and sweat glands. Their absence reduces tactile sensitivity, impairs...
01:27Degenerative Disc Disease I: Introduction
Degenerative disc disease is a chronic condition in which intervertebral discs gradually lose structure and function. It is not infectious or autoimmune; rather, it results from age-related biochemical and mechanical changes, influenced by genetic, metabolic, and environmental factors.Structure and Function of DiscsThe spine contains 23 intervertebral discs that absorb load, distribute forces, maintain spacing, and allow flexibility. Each disc consists of a nucleus pulposus, a gel-like core...