初次髋关节置换的术前计划

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1、西京骨科初次髋关节置换第四军医大学第一附属医院全军骨科研究所朱庆生THA的历史Intertrochantericosteotomy1822AWhite1826JRBarton1863SayreCreatedapsuedarthrosiswhicheliminatedpainandmaintainedmobilityTHA的历史InterpositionalArthroplasty1885OllierSofttissue1902MurphyFascialata1913LoeweSkin1918BaerPig’sbladderInterpositionofdifferentmate

2、rialstopreventrecurrencebonegrowthandmaintainmotionTHA的历史Non-biologicalmaterialsusedGoldfoil金箔Silverfoil银箔Platinum箔Magnesium镁Aluminium铝Glass玻璃THA的历史MoldCupArthroplastySmith-Petersen1923Glass玻璃1933Pyrex耐热玻璃1937Bakelite塑料1938Vitalium合金ProvedthattheacetabulumwilltolerateaforeignbodyTHA的历史Smith-

3、PetersendoublecupAmetalsurfacereplacementfemoralcomponentandapolymeracetabularcomponentTHA的历史ReplacementArthroplasty1943JudetacrylicandmetalsurfacereplacementAdevelopmentofthesurfacereplacementAcruciform十字形stemwasaddedtoimprovefixationandstabilityTHA的历史ReconstructiveArthroplasty1945Girdlesto

4、neResectedtheheadoftenusedasarevision/salvageprocedureThemusclesaroundthehipandtheacetabulumformedasofttissuejointThismaintainedmotionandcreatedapainfreestablehipduringthepre-totalhiperaTHA的历史1950ThompsonLargeheadandcollarcurvedintramedullarycementedstem1952MooreLargeheadandcollarlongstraigh

5、tcementlessstemwithfenestrationsforboneingrowthHemi-ArthroplastyTHA的历史JohnCharnley(1911-1982)THA的历史Charnley’sContributionLaboratoryexperimentsonthefrictionandlubricationofjointsduringthe1950’s1958useofPolytetrafluoroethylene(PTFE)doublecupdesign300caseshadtoberevisedwithin3to4yearsduetosever

6、ecomponentwearTHA的历史Charnley’sLow-frictionarthroplastyprinciple股骨头和髋臼之间的摩擦力可引起假体磨损继之导致假体松动可以通过减小股骨头的直径来减小摩擦力髋臼假体的强度可以通过增加髋臼比的厚度而得到加强THA的历史1960’sCharnleydefinestotalhipsurgeryUseofpolymethylmethacrylatePMMAbonecementIntroductionofHigh-DensityPolyethyleneTrochantericosteotomyforbetterexposurea

7、ndadjustmentoftheabductorsTHA的历史Charnley对THA最大的贡献就是使用了高分子聚乙烯臼杯（大）不锈钢的股骨头（小）股骨柄的近端髓内固定骨水泥固定技术今天全髋置换获得巨大成功THA的历史关节置换的主要目的：消除关节疼痛改善关节功能初次的髋关节置换是能够获得满意疗效的一种治疗手段。西京骨科西京骨科初次全髋置换手术成功率病人满意率手术方法简单?1623例初次THA术后6个月随访98%希望对侧肢体作THA96%希望原术者主刀目前THA获得成功主要基于医生：对疾病