カップ関節形成術後に人工股関節置換術を施行した4例
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- 資料種別
- 記事
- 著者・編者
- 丹藤 世身藤田 貴也船山 敦 他
- 並列タイトル等
- Revision Total Hip Replacement after Cup Arthroplasty : A Report of Four Cases
- タイトル（掲載誌）
- 日本関節病学会誌 = Japanese journal of joint diseases
- 巻号年月日等（掲載誌）
- 30(4):2011
- 掲載巻
- 30
- 掲載号
- 4
- 掲載ページ
- 503-508
- 掲載年月日（W3CDTF）
- 2011
- ISSN（掲載誌）
- 1883-2873
- ISSN-L（掲載誌）
- 1883-2873
- 出版事項（掲載誌）
- 東京 : 日本関節病学会
- 出版地（国名コード）
- JP
- 本文の言語コード
- jpn
- NDLC
- 対象利用者
- 一般
- 所蔵機関
- 国立国会図書館
- 請求記号
- Z19-1352
- 連携機関・データベース
- 国立国会図書館 : 国立国会図書館雑誌記事索引
- 書誌ID（NDLBibID）
- 023479983
- 整理区分コード
- 632
- 要約等
- Cup arthroplasty used to be performed for osteoarthritis of the hip in younger patients in order to preserve bone stock in our hospital. We report four cases of total hip arthroplasty (THA) after cup arthroplasties.<br><b>Case 1.</b> The patient was a 51-year-old woman. She was diagnosed with osteoarthritis of the hip secondary to developmental dislocation of the hip (DDH) and underwent a left cup arthroplasty at the age of 23 years. Twenty-eight years later she underwent left THA. During the operation, it was very difficult to pull down the femur, and the procedure resulted in a distal femur fracture. <br><b>Case 2.</b> The patient was a 62-year-old woman. She was diagnosed with osteoarthritis of the hip secondary to DDH and underwent a right cup arthroplasty at the age of 38 years. Twenty-four years later she underwent right THA. The formation of osteophyte in the acetabulum prevented dislocation of the femoral head. In situ osteotomy of the femoral neck was necessary.<br><b>Case 3.</b> The patient was a 78-year-old woman. She was diagnosed with rheumatoid arthritis and underwent a left cup arthroplasty at the age of 49 years. Twenty-nine years later, she underwent left THA due to pain progression and leg length discrepancy. The weakness of the bone resulted in a fracture in the superior margin of the obturator foramen, resulting in the migration of acetabular reinforcement. She underwent a repeat operation.<br><b>Case 4.</b> The patient was a 43-year-old man. He was diagnosed with post-traumatic osteoarthritis of the hip and underwent a right cup arthroplasty at the age of 31 years. Twelve years later, he underwent right THA. <br> In these four cases, THAs were performed on average 23 years after cup arthroplasties, and the Hip score, as defined by the Japanese Orthopaedic Society, improved from 41.8 points preoperatively to 71.3 points at the final follow-up. The features of patients who have undergone cup arthroplasty include a poor range of motion and leg length discrepancy due to migration of the cup. The problem is that surgeons have difficulty in pulling down the femur to deal with acetabular cavitary bone defects during the operation. It was very useful to use modular-neck stems and transplant the bone with acetabular reinforcements. In conclusion, we recommend that cup arthroplasties be converted to THAs before the cups migrate severely into the acetabulum.
- DOI
- 10.11551/jsjd.30.503
- オンライン閲覧公開範囲
- インターネット公開
- 連携機関・データベース
- 科学技術振興機構 : J-STAGE
- 要約等
- Cup arthroplasty used to be performed for osteoarthritis of the hip in younger patients in order to preserve bone stock in our hospital. We report four cases of total hip arthroplasty (THA) after cup arthroplasties.<br><b>Case 1.</b> The patient was a 51-year-old woman. She was diagnosed with osteoarthritis of the hip secondary to developmental dislocation of the hip (DDH) and underwent a left cup arthroplasty at the age of 23 years. Twenty-eight years later she underwent left THA. During the operation, it was very difficult to pull down the femur, and the procedure resulted in a distal femur fracture. <br><b>Case 2.</b> The patient was a 62-year-old woman. She was diagnosed with osteoarthritis of the hip secondary to DDH and underwent a right cup arthroplasty at the age of 38 years. Twenty-four years later she underwent right THA. The formation of osteophyte in the acetabulum prevented dislocation of the femoral head. In situ osteotomy of the femoral neck was necessary.<br><b>Case 3.</b> The patient was a 78-year-old woman. She was diagnosed with rheumatoid arthritis and underwent a left cup arthroplasty at the age of 49 years. Twenty-nine years later, she underwent left THA due to pain progression and leg length discrepancy. The weakness of the bone resulted in a fracture in the superior margin of the obturator foramen, resulting in the migration of acetabular reinforcement. She underwent a repeat operation.<br><b>Case 4.</b> The patient was a 43-year-old man. He was diagnosed with post-traumatic osteoarthritis of the hip and underwent a right cup arthroplasty at the age of 31 years. Twelve years later, he underwent right THA. <br> In these four cases, THAs were performed on average 23 years after cup arthroplasties, and the Hip score, as defined by the Japanese Orthopaedic Society, improved from 41.8 points preoperatively to 71.3 points at the final follow-up. The features of patients who have undergone cup arthroplasty include a poor range of motion and leg length discrepancy due to migration of the cup. The problem is that surgeons have difficulty in pulling down the femur to deal with acetabular cavitary bone defects during the operation. It was very useful to use modular-neck stems and transplant the bone with acetabular reinforcements. In conclusion, we recommend that cup arthroplasties be converted to THAs before the cups migrate severely into the acetabulum.
- DOI
- 10.11551/jsjd.30.503
- 関連情報（URI）
- 連携機関・データベース
- 国立情報学研究所 : CiNii Research
- 提供元機関・データベース
- Japan Link Center雑誌記事索引データベースCiNii Articles
- 書誌ID（NDLBibID）
- 023479983
- NII論文ID
- 130004955685