ABSTRACT
BACKGROUND:With the wide application and in-depth research of artificial hip joint, more secondary fractures around femoral prosthesis are reported. OBJECTIVE:To investigate the reasons, preventive measures, classification and treatment method of fractures around femoral prosthesis after artificial hip replacement. METHODS:The clinical data of the type classification, treatment method and clinical efficacy of fractures around femoral prosthesis after artificial hip replacement were retrospectively analyzed. The multi-level study was performed to investigate the trend of the relevant literatures. According to the Vancouver classification criteria, the various types of fractures and the results and complications of various treatment methods were analyzed, the treatment methods of different fractures were identified, and the effective and objective evaluation criteria were established to provide references for the clinical treatment. RESUTLS AND CONCLUSION:The fractures around femoral prosthesis after artificial hip replacement were closely related with the age of the patients, basic diseases, osteoporosis and selection of prosthesis type. The Vancouver classification criteria and treatment programs have guiding significance to the clinical efficacy. The fractures should be treated with different methods according to the different types in order to promote the fracture healing. The fractures around femoral prosthesis after artificial hip replacement were commonly treated with shape memory alloy embracing fixator, minimal y invasive fixation system, locking compression plate, al ograft cortical bone plates, carbon fiber, impaction bone grafting and renovation. In the practice application, various methods are often used in combination. For the patients with B2 and B3 type fractures, we should pay attention to the bone grafting around the fractures and the inner and outer medul ary cavity.
ABSTRACT
BACKGROUND:Al ogenic bone is a clinical commonly used bone graft material, but the osteoinductive capacity is the biggest problem. OBJECTIVE:To evaluate the effect of al ogeneic bone combined with autologous bone marrow stem cells on the repair of bone defects after scraping or resection of benign bone tumors and tumor-like lesions. METHODS:Sixty-five cases of benign bone tumors (including patients with tumor-like lesions) were divided into two groups according to bone graft. There were 35 cases in the composite bone marrow stem cells for bone graft group, and 20-40 mL red bone marrow were extracted from anterosuperior iliac spine or iliac spine on both sides according to the expected amount of bone graft, then the bone marrow stem cells were isolated, purified, cultured and amplified for standby, and the bone marrow stromal stem cells and al ogeneic bone particles were ful y blended before bong graft. After tumor scraping or resection, the blended bone marrow stromal stem cells and al ogeneic bone particles were implanted into the bone defect region. In the bone graft group, the bone defect was implanted with al ogeneic bone soaked with saline for half an hour. X-ray examination was performed at 1, 3, 6 and 12 months after treatment to compare the fuzzy boundary and the time for disappear, and the postoperative complications were observed. RESULTS AND CONCLUSION:Al the 62 patients were fol owed-up for more than 12 months. The fuzzy boundary time and disappear time in the composite bone marrow stem cells for bone graft group were shorter than those in the bone graft group (P<0.05). In the composite bone marrow stem cells for bone graft group, one case appeared rejection and healed after treated with immunosuppressive agents for 2 weeks, and no complication observed in two groups. The results indicate that al ogeneic bone composite autologous bone marrow stem cells for bone graft can promote bone fusion and bone defect healing.