该病例描述了由于松动而对上踝关节假体进行的修正。当踝关节置换是首选且实际骨质量不允许假体置换时,关节固定术是减轻疼痛和获得稳定的唯一方法。由于移除的假体导致的骨缺失量是严重的。鲨鱼螺丝®,由人类同种异体皮质骨制成,用于将同种异体股骨头和胫骨以及腓骨和距骨彼此固定以进行稳定。这是在没有任何自体骨移植和没有金属螺钉的情况下进行的。皮质同种异体移植物的人基质允许产生新血管,然后进行成骨细胞活动和产生新骨。同种异体移植物的血运重建降低了感染和伤口问题的风险。随着时间的推移,患者的骨代谢允许同种异体移植物被重塑成患者的骨。此处报告的病例有严重的多发病。假体松动主要影响家务能力,移动性,享受休闲,它对病人的情绪和幸福有很大的影响。手术一年后,患者非常满意,能够行走约90分钟没有疼痛和划痕。
The
case describes the revision of an upper ankle prosthesis because of loosening. When ankle replacement is the first choice and actual bone quality does not allow a replacement of the prosthesis, arthrodesis is the only way of reducing pain and gaining stability. The amount of missing bone due to the removed prosthesis was severe. Shark Screws®, made of human allograft cortical bone, were used to fix an allograft femoral head and tibia as well as fibula and talus to each other for stabilization. This was performed without any autologous bone graft and without metal screws. The human matrix of the cortical allograft allows the creation of new vessels followed by osteoblastic activity and production of new bone. The revascularization of the allografts reduces the risk of infection and wound problems. Over time, the patient\'s bone metabolism allows the allografts to be remodeled into the patient\'s bone. The
case reported here had severe multimorbidity. The loosening of the prosthesis mainly affected the ability to perform housework, mobility, enjoying leisure, and it had a great impact on the emotion and well-being of the patient. One year after surgery, the patient is very satisfied to be able to walk without pain and scratches for about 90 min.