关节置换的新概念精品医学ppt课件

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1、CURRENTCONCEPTSINJOINTREPLACEMENTTMSPRING2004Thecourseobjectivesare:◆Tofacilitatefaculty/participantdiscussiononcontemporaryhip,kneeandshoulderarthroplastyuseinclusiveofdesignconcepts,materialadvancesandclinicalresults.◆Topresentsolutionstodifficulthip,kneea

2、ndshouldermanagementproblemsaswellassurgicaltechniqueswhichassisttheirsolution.◆Toevaluatetheuseofcurrentfixationmethodsinprimaryandrevisionproceduresincludingcement,hydroxyapatite,porouscoated,pressfitandimpactiongraftingapplications.◆Toaddresscurrentconcer

3、nsregardingimplantmateriallimitationsandbiologicresponseaswellasidentifyclinicalinterventionstrategies.◆使会议参加者对当前髋关节、膝关节及肩关节的成形进行讨论，包括设计概念、材料发展和临床效果。◆提出对疑难的髋关节，膝关节肩关节如何解决的问题，以及相关的外科技术。◆评价当前的固定方法在原发和翻修操作步骤的应用，包括骨水泥压迫嵌入、压迫移植应用。发表当前一些新概念，如材料的研制、生物反应、以及确认临床发展的方向

4、。HipArthroplasty:I.IntroductionA.Demographics◆Morethan220,000fracturesofthehipoccureachyearinNorthAmerica.◆Cost-greaterthan9billiondollarhealthcarecostsperyear.◆eterogeneouspatientpopulation-somepatientsareactivecommunityambulatorsbutmanyarenursinghomereside

5、nts.B.Issues◆Optimaltreatmentofdisplacedfemoralneckfracturesremainscontroversial.◆Generalagreementthatpatientsregardlessofagewithnon-displacedorvalgusimpactedfractures(stable)willbetreatedwithinternalfixation.◆Generalagreementthathealthypatients60yearsoryoun

6、geraregoodcandidatesforinternalfixation.◆However,treatmentofpatientsolderthan60yearsofageiscontroversial.C.TreatmentOptions◆Internalfixation◆ArthroplastyII.Questions1.Whichpatientswithdisplacedfemoralneckfracturesshouldbetreatedwithinternalfixation?◆Factorst

7、hatshouldbeconsideredincludeage,fracturetype,activitylevelandoverallhealth2.Shouldpatientsbeingtreatedwithanarthroplastyprocedurereceiveaunipolar,bipolarortotalhiparthroplasty?3.Isthereevidencebasedinformationtosupportthesedecisions?III.InternalFixationversu

8、sProstheticReplacementA.ClinicalData1.ObservationalStudies◆Valuelimitedbyretrospectivedesign,potentialselectionbias2.Randomizedtrials◆Biasdecreasedbyrandomization◆However,randomizedtrialsassesse