revisioni protesi anca
DESCRIPTION
Padova 15 – 16 ottobre 2010 www.casacura.it 8-01-2011 Padova 15 – 16 ottobre 2010 www.casacura.it 8-01-2011 8-01-20113 8-01-20114 8-01-20115 8-01-20116 8-01-20117 8-01-20118 Cementata Non cementata 8-01-20119 8-01-201110 8-01-201111 MOBILIZZAZIONE ASETTICA COTILE 8-01-201112 IL DIFETTO OSSEO CONDIZIONA LA REVISIONE ACETABOLARE 8-01-201113 I. Difetto cavitario II. Difetto colonnare Semplice (< 50%) 8-01-201114 IV. Discontinuità pelvica III. Difetto colonnare Complesso (> 50%) 8-01-201115TRANSCRIPT
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8-01-2011
Masterclass Hip Revision Padova 15 – 16 ottobre 2010
www.casacura.it
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8-01-2011
Masterclass Hip Revision Padova 15 – 16 ottobre 2010
www.casacura.it
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Cementata Non cementata
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MOBILIZZAZIONE ASETTICA COTILE
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MOBILIZZAZIONE ASETTICA COTILE
IL DIFETTO OSSEO CONDIZIONA LA
REVISIONE ACETABOLARE
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I. Difetto cavitario II. Difetto colonnare Semplice (< 50%)
Innesto di osso spugnoso + nuovo acetabolo
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III. Difetto colonnare Complesso (> 50%)
IV. Discontinuità pelvica
Innesto osseo strutturale +/- anello di rinforzo
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Quattro criteri Radiografici
1) Linea di Kohler 2) Tear drop 3) Lisi ischiatica 4) Migrazione prossimale
1 2
3
4
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1 ) Linea di Kohler - Integrità del muro mediale e della colonna antero-superiore 2) Tear drop - Integrità del muro mediale e della porzione inferiore delle colonne anteriore e posteriore 3) Lisi ischiatica - Integrità del muro posteriore e della colonna posteriore 4) Migrazione prossimale - Integrità della cupola superiore
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1 ) Proiezione di Judet ( obliqua iliaca e otturatoria) - Può aiutare a evidenziare la lisi retroacetabolare 2) CT - Può dare indicazioni sull’entità e l’estensione della lisi
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Classificazione di Paprosky del difetto femorale
Della Valle CJ and Paprowsky WG – Classification and Algorithmic approach to the reconstruction of femorale deficiency in Revision Total Hip Artrhroplasty. – J Bone Joint Surg Am. 85; 1-6, 2003
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Classificazione del difetto femorale
Metafisi
Diafisi
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Classificazione del difetto femorale
Metafisi
Diafisi
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Sostanze coinvolte nella formazione dei detriti
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Sostanze coinvolte nella formazione dei detriti
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Sostanze coinvolte nella formazione dei detriti
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Sostanze coinvolte nella formazione dei detriti
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Sostanze coinvolte nella formazione dei detriti
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Sostanze coinvolte nella formazione dei detriti
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Sostanze coinvolte nella formazione dei detriti
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Sostanze coinvolte nella formazione dei detriti
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Sostanze coinvolte nella formazione dei detriti
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Sostanze coinvolte nella formazione dei detriti
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Sostanze coinvolte nella formazione dei detriti
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Sostanze coinvolte nella formazione dei detriti
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Sostanze coinvolte nella formazione dei detriti
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18 anni
17 anni 18 anni
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19 anni
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18 anni 8 anni
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17 anni
1 anno post-op
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Soluzioni
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8 anni
19 anni
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Soluzioni
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B2
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B2
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Soluzioni
- Sostituzione della componente rotta
- Problemi con le testine in ceramica rotte
- Difficoltà nella rimozione dello stelo femorale ( tecnica della Finestra Ossea )
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Soluzioni
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..e ricordiamo sempre che..
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