By Dr Pierre Le Béguec, Dr Hans-Peter Sieber (eds.)
The writer of this multimedia paintings units himself an bold aim: to permit a health professional to accomplish the revision of a prosthesis with no too many problems (or an excessive amount of apprehension!) with assured effects if he follows the proposed process step-by-step, and this, no matter if he isn't very skilled during this discipline.To fulfil this function, the writer presents a transparent definition of the press-fit inspiration (principles and functional purposes) and from there, he deals a logical and rigorous approach for, to start with, making plans the surgical procedure, after which, acting it.The written textual content is additionally on hand as a automated slide exhibit, coming with a searching approach to be able to make a pre-operative making plans, which provides genuine pedagogic price to the total of this work.
Read Online or Download Revision of Loose Femoral Prostheses: With a Stem System Based on the “Press-Fit” Principle: A Concept and a System of Implants: A Method and Its Results PDF
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Additional info for Revision of Loose Femoral Prostheses: With a Stem System Based on the “Press-Fit” Principle: A Concept and a System of Implants: A Method and Its Results
This choice however makes a long stem necessary which is clearly undesirable. The authors prefer in those cases to implant a short, stem with a very proximal press-fit fixation, using an endofemoral Figure 3 approach (for straight femur in the frontal view) or by means of a trochanteric osteotomy, with an additional longitudinal osteotomy of the proximal femur in order to reduce its diameter with the help of circular wire cerclage. As an alternative, local impaction grafting may be helpful too in order to ensure a tight epiphyseal contact zone with the prosthesis (see also ﬁg.
10 A) or the double axial curving (ﬁg. 10 B). Figure 10A Figure 10B 48 Second part – Preoperative planning NB. A double axial curving means that the diaphyseal recurvation is being compensated by a proximal antecurvation, thus resulting globally in a very slight deformity of the femur in the sagittal plane. In general these curvings are not an obstacle to the insertion of a straight stem, because in both cases it will be possible to prepare the femur on a sufﬁcient distance for the press-ﬁt implantation of the straight stem.
Curvature of the femur or difﬁculties in excision of the cement). To establish a strategy for the operation means to perform at least a precise and complete analysis of the whole femur. For this purpose, 4 x-rays are required: An a-p-view of the pelvis, the concerned hip (centered on the loose prosthesis), the hip ap and axially, with a distance of 15 cm distally to the tip of the loose prosthesis. Considering the large amount of incomplete x-ray investigations in daily practice, this point is of utter importance.