CURRENTCONCEPTSINJOINTREPLACEMENTTMSPRING2004Thecourseobjectivesare:◆Tofacilitatefaculty/participantdiscussiononcontemporaryhip,kneeandshoulderarthroplastyuseinclusiveofdesignconcepts,materialadvancesandclinicalresults.◆Topresentsolutionstodifficulthip,kneeandshouldermanagementproblemsaswellassurgicaltechniqueswhichassisttheirsolution.◆Toevaluatetheuseofcurrentfixationmethodsinprimaryandrevisionproceduresincludingcement,hydroxyapatite,porouscoated,pressfitandimpactiongraftingapplications.◆Toaddresscurrentconcernsregardingimplantmateriallimitationsandbiologicresponseaswellasidentifyclinicalinterventionstrategies.第一页，共六十三页。◆使会议参加者对当前髋关节、膝关节及肩关节的成形进行讨论，包括设计概念、材料发展和临床效果。◆提出对疑难的髋关节，膝关节肩关节如何解决的问题，以及相关的外科技术。◆评价当前的固定方法在原发和翻修操作步骤的应用，包括骨水泥压迫嵌入、压迫移植应用。发表当前一些新概念，如材料的研制、生物反应(fǎnyìng)、以及确认临床发展的方向。第二页，共六十三页。HipArthroplasty:I.IntroductionA.Demographics◆Morethan220,000fracturesofthehipoccureachyearinNorthAmerica.◆Cost-greaterthan9billiondollarhealthcarecostsperyear.◆eterogeneouspatientpopulation-somepatientsareactivecommunityambulatorsbutmanyarenursinghomeresidents.B.Issues◆Optimaltreatmentofdisplacedfemoralneckfracturesremainscontroversial.◆Generalagreementthatpatientsregardlessofagewithnon-displacedorvalgusimpactedfractures(stable)willbetreatedwithinternalfixation.◆Generalagreementthathealthypatients60yearsoryoungeraregoodcandidatesforinternalfixation.◆However,treatmentofpatientsolderthan60yearsofageiscontroversial.C.TreatmentOptions◆Internalfixation◆Arthroplasty第三页，共六十三页。II.Questions1.Whichpatientswithdisplacedfemoralneckfracturesshouldbetreatedwithinternalfixation?◆Factorsthatshouldbeconsideredincludeage,fracturetype,activitylevelandoverallhealth2.Shouldpatientsbeingtreatedwithanarthroplastyprocedurereceiveaunipolar,bipolarortotalhiparthroplasty?3.Isthereevidencebasedinformatio...
