人工髋关节假体设计新进展:聚焦降低脱位发生率
New progress in the design of artificial hip prosthesis:focusing on reducing the dislocation rate
摘要Dislocation and instability are the primary reasons for the failure of total hip arthroplasty.This article briefly reviews the recent advancements in hip prosthesis design aiming at enhancing stability and reducing the rate of dislocation.These advancements include the selection of larger-diameter femoral heads to increase the head-to-neck ratio of the prosthesis;the selective use of dual-mobility articulations,constrained liners,or lipped liners;adjustable anteversion femoral stems that allow for flexible adjustment of the anteversion intraoperatively to achieve an ideal combined hip anteversion,thereby minimizing dislocation;and the selection of high-offset femoral stems when necessary to achieve appropriate abductor muscle tension without affecting lower limb length,restoring the biomechanical properties of the hip joint,increasing range of motion,and reducing the rate of dislocation.Additionally,newly developed reverse hip arthroplasty systems aiming at increasing stability are introduced.In the future,further improvements in prosthesis design are needed to enhance joint range of motion and stability.Meanwhile,it is essential to establish a joint replacement registration system in China to study the indication and clinical outcomes of various prosthesis designs with different characteristics.
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