Hip Fixation

Hip Fixation

髖關節固定

​

The Goal of Implant Fixation:

種植體固定的目標：

​

Eliminate relative motion between

loaded implant & supporting bone

消除加載的種植體和支撐骨之間的相對運動

​

Multiple Select

What are 2 types of fixation in Total Hip Replacement?

全髖關節置換術中的兩種固定方式是什麼？

• Cement

  水泥

• Biologic

  生物的

• Glue

  膠水

• Heat

  熱

Cementless stem for

無水泥閥桿適用於

• High activity level (higher loading stress -> cement cracks at stress points) 高活性水平（更高的載荷應力 -> 應力點處的水泥裂縫）

• Young age (cement would cyclically fatigue over time) 年輕（水泥會隨著時間的推移週期性疲勞）

  DORR type A & B (DORR A & B 型)

Poll

Which fixation types are the most popular in your country?

哪種固定類型在您的國家最受歡迎？

• Cemented stem

  水泥桿

• Cementless stem

  無水泥閥桿

• Cemented cup

  水泥杯

• Cementless cup

  無水泥杯

Multiple Choice

Which fixation for acetabular cups has better long-term results?

哪種髖臼杯固定具有更好的長期效果？

• Cemented

  膠結

• Cementless

  無水泥

Multiple Select

Where are cemented stems used?

水泥桿用在什麼地方？

• Elderly patients

  老年患者

• Irradiated bone

  輻照骨

• DORR type C

  DORR C型

• Active patients

  活躍患者

Bone cement

骨水泥

• Powder polymer 粉末聚合物

• Liquid monomer 液態單體

• Antibiotics 抗生素

Multiple Choice

When cement is prepared in the operating theatre, 

it will _______ before it hardens

在手術室中製備水泥時，它會在硬化前_______

• get cold

  變得更冷

• get hot

  變得更熱

Good cementing technique

良好的固井技術

• clean & dry the bone 清潔並擦乾骨頭

• pressurize cement 給水泥加壓

• reduce porosity in cement 減少水泥中的孔隙率

Multiple Choice

Which cemented stem is designed to subside slightly into the cement mantle?

哪個水泥桿被設計成稍微下沉到水泥地幔中？

Cementless fixation requires long-term Biologic Fixation

非骨水泥固定需要長期生物固定

• Bone ingrowth 骨長入

• Bone ongrowth 骨骼生長

Multiple Select

Which of the following surfaces are designed for bone ingrowth?

以下哪些表面是為骨長入而設計的？

Multiple Select

Which of the following surface treatments are designed primarily for bone ongrowth?

以下哪些表面處理主要用於骨骼生長？

• Plasma spray

  等離子噴塗

• Grit blast

  噴砂

• Hydroxyapatite coating

  羥基磷灰石塗層

• Porous Tantalum

  多孔鉭

Cementless fixation = Initial Fixation + long term biologic fixation.

非骨水泥固定 = 初始固定 + 長期生物固定。

​

2 types of initial fixation:

2 種類型的初始固定：

• Press-Fit 壓合

• Line-to-line 線對線

Multiple Choice

The surgeon reams the acetabulum to 52mm. However he chooses a 54mm cup to implant. What did the surgeon choose to do?

外科醫生將髖臼鉸孔至 52 毫米。然而，他選擇了一個 54 毫米的杯子進行植入。外科醫生選擇做什麼？

• Line-to-line

  線對線

• Cement

  水泥

• Press-fit

  壓配合

Multiple Choice

Proximally coated stems loads the ________ bone.

Extensively coated stems loads the _______ bone.

近端有塗層的莖會加載 ________ 骨。廣泛塗覆的莖加載_______骨。

• distal, proximal

  遠端，近端

• proximal, distal

  近端，遠端