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1、Author|PowerPointtitlegoeshere|AprilXX,2012CORAIL SYSTEM1优选课件Author|PowerPointtitlegoeshere|AprilXX,2012 CORAIL SYSTEM DESIGNERSARTRO GROUP FOUNTED IN 19812优选课件Author|PowerPointtitlegoeshere|AprilXX,20121984TITANstemlaunched钛合金柄上市1985ClinicaltrailsofTITAN/HA临床试验19861stimplantationoftheCORAILstem 第一个
2、假体柄植入体内1996FDAapprovalFDA通过 2005 CorailAMTHISTORICAL RECORD历史回顾3优选课件Author|PowerPointtitlegoeshere|AprilXX,2012CORAIL DESIGN PRINCIPL设计原理SURFACE TREATMENT表面处理RANGE OF IMPLANTS假体尺寸SURGICAL TECHNIQUE外科技术CLINICAL RESULTS临床结果4优选课件Author|PowerPointtitlegoeshere|AprilXX,2012RELIABLEPRIMARYSTABILITY可靠的初始稳定
3、性LONGTERMBIOLOGICALFIXATION长期的生物固定PROXIMALLOADTRANSFER近端负荷传导CORAIL DESIGN PRINCIPLES设计原理5优选课件Author|PowerPointtitlegoeshere|AprilXX,2012CORAIL DESIGN PRINCIPLES设计原理6优选课件Author|PowerPointtitlegoeshere|AprilXX,2012FEMORALHEADS股骨头Alumina(BioloxForte)氧化铝Tribologicalproperties摩擦学属性Compatiblewithaluminaor
4、cobaltchromeliners与氧化铝或钴铬内衬匹配CORAIL DESIGN PRINCIPLES设计原理7优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Straightstem直柄Thindistaltip远端较细CORAIL DESIGN PRINCIPLES设计原理8优选课件Author|PowerPointtitlegoeshere|AprilXX,2012135neckangle 颈干角12/14Morsetaper锥度Progressiveoffset 偏心距逐渐扩大CORAIL DESIGN PRINCIPLES设计原理9优
5、选课件Author|PowerPointtitlegoeshere|AprilXX,2012四边形横截面轴向及旋转稳定性CORAIL DESIGN PRINCIPLES设计原理10优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Doubletapergeometrygivesstero-stability 双锥度设计提供 立体稳定性CORAIL DESIGN PRINCIPLES设计原理11优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Progressivehorizontalmacrostructu
6、reontheproximalstem柄的近端逐渐扩大的横行结构CORAIL DESIGN PRINCIPLES设计原理12优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Horizontalproximalmacrostructure近端横行结构Size9=11grooves沟Size20=21grooves沟CORAIL DESIGN PRINCIPLES设计原理13优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Verticaldistalmacrostructre远端垂直结构CORAIL DES
7、IGN PRINCIPLES设计原理14优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Optionalcollarforcalcarloading股骨距负荷-带领，不带领CORAIL DESIGN PRINCIPLES设计原理15优选课件Author|PowerPointtitlegoeshere|AprilXX,2012HYDROXYAPATITEBioactivecoating生物活性涂层CORAIL DESIGN PRINCIPLES设计原理16优选课件Author|PowerPointtitlegoeshere|AprilXX,2012B
8、ONE COMPOSITION骨组成ORGANIC PHASE 有机期 30%collagen胶元, specificproteins特殊蛋白质MINERAL PHASE 矿物质期 60%carbonatedapatite碳酸磷灰石WATER 水 10%17优选课件Author|PowerPointtitlegoeshere|AprilXX,2012HYDROXYAPATITE羟基磷灰石ChemicalFormula化学分子式Ca10(PO4)6(OH)2Similartothemineralphaseofhumanbone与人类骨的矿物质期相似 Biocompatible,nonresorb
9、able生物相容，不可吸收Osteo-conductiveproperties骨传导性18优选课件Author|PowerPointtitlegoeshere|AprilXX,2012NONTOXIC无毒NONINFLAMMATORY不引起炎症反应NONALLERGIC无过敏反应NONCARCINOGENIC不引起癌症HYDROXYAPATITE19优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Coatingthickness涂层厚度 = 150mCoatings200mriskofdelamination 脱层的危险HYDROXYAPATITE
10、20优选课件Author|PowerPointtitlegoeshere|AprilXX,2012ADVANTAGES优点Increasedboneingrowth 增加骨内生Nofibroustissueinterposition无纤维组织插入Gapfilling孔隙充填HYDROXYAPATITE21优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Newboneformation 新骨形成HAcoatingHA涂层Metal 金属HYDROXYAPATITENO FIBROUS TISSUE INTERPOSITION 无纤维组织插入22优选课
11、件Author|PowerPointtitlegoeshere|AprilXX,2012HYDROXYAPATITEWhyisCorailfullycoated?为何全涂层？Longtermstability长期的稳定性Biologicalsealagainstweardebris生物性封闭，以抵抗磨屑Nodistalgranulomas没有远端肉芽肿23优选课件Author|PowerPointtitlegoeshere|AprilXX,2012LONGTERMSTABILITY长期稳定性“The complete absence of femoral endosteal cortical
12、osteolysis in spite of the abundance of particles is reassuring. The explanation may be that the extensive HA coating of the stem seals the whole interface and blocks the passage of particles.” 虽然有大量的磨损颗粒，但没有股骨骨内膜的皮质骨溶解。原因可能是广泛的HA涂层封闭了所有的交界面阻止了微粒的通道。RokkumetalJBJSVol81B,1999HYDROXYAPATITE24优选课件Autho
13、r|PowerPointtitlegoeshere|AprilXX,2012Preventionofthighpain大腿痛的防止 Nofibroustissuedistally远端没有纤维组织Nodistalmicromotion没有远端微动Minimisethighpain最小化大腿痛NewboneformationHYDROXYAPATITE25优选课件Author|PowerPointtitlegoeshere|AprilXX,2012From Corail to Corail AMT26优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Ar
14、ticul / eze Mini Taper: AMTThinnerneck更薄的颈部设计=Improvedrangeofmotion更大的活动度27优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Polishedtaper 抛光的锥部BetterresistancetoPEwear减少PE磨损Articul / eze Mini Taper: AMT28优选课件Author|PowerPointtitlegoeshere|AprilXX,2012 AMT taperOld taperMinitaper短小的锥部12/14Improvedrange
15、ofmotion 更大的ROMNoskirteffect无假裙现象Articul / eze Mini Taper: AMT29优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Thinnerneck更薄的颈部设计Elliptico-trapezoidalshape2flatsurfacesFrontal(向位):12mmSagittal(矢向位): 9.15 mmArticul / eze Mini Taper: AMT30优选课件Author|PowerPointtitlegoeshere|AprilXX,2012New impaction ho
16、le新打入孔Articul / eze Mini Taper: AMT31优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Standard range:KSAvailablesizes:(new)8;9;10;11;12;13;14;15;16;18;20WithoutcollaroutsideofFranceNSA:135Indications:PrimaryTHR;Revisionstage1and232优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Articul / eze HeadsCobal
17、tchrome-22.225mm:+4medium+7long33优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Cobaltchrome:28mm: +1.5 shortneck+5medium(standard)+8.5 long+12 extralongArticul / eze Heads34优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Articul / eze RangeCeramic:28mm,36mm:+1.5 shortneck+5medium(Standard)+8.5 long3
18、2mm: +1shortneck+5medium(Standard)+9long35优选课件Author|PowerPointtitlegoeshere|AprilXX,201297.7%Survivorshipat10years89%ofpatientswithoutthighpain(大腿痛）0.8%stressshieldingGr.III应力遮挡JP Vidalain and the Artro Group International Corail Conference, 1998CORAIL Clinical results36优选课件Author|PowerPointtitlego
19、eshere|AprilXX,2012100%Survivorshipin100casesafter5years0%Thighpain大腿痛0%Stressshielding应力遮挡0%migration移动Rokkum et al Journal of Arthroplasty Vol.14, 1999CORAIL Clinical results37优选课件Author|PowerPointtitlegoeshere|AprilXX,2012NORWEGIANHIPREGISTER99.5%Survivorshipin1117casesat4.5years Havelin L et al
20、JBJS Vol. 77-B, 1995CORAIL Clinical results38优选课件Author|PowerPointtitlegoeshere|AprilXX,2012INPATIENTSUNDER50years99.1%Survivorshipin119casesafter10yearsVidalain JP et al European Hip Society, 1998CORAIL Clinical results39优选课件Author|PowerPointtitlegoeshere|AprilXX,2012INPATIENTSUNDER55years94.4%Surv
21、ivorshipin1039casesafter6yearsHavelin L et al JBJS Vol.79-B, 1997CORAIL Clinical results40优选课件Author|PowerPointtitlegoeshere|AprilXX,201295.1% Survivorship in 5,130 cases at 15 yearsThe Norwegian Arthroplasty Register，1987-2004, 2005.迄今为止最成功生物型股骨假体ClinicalHeritageDocumented41优选课件Author|PowerPointtit
22、legoeshere|AprilXX,2012FEATUREQUADI-LATERAL CROSS SECTION 横截面四边形BENEFITACCURATE ROTATIONAL STABILITY 精确的旋转稳定性CORAIL 42优选课件Author|PowerPointtitlegoeshere|AprilXX,2012FEATUREMACROSTRUCTURE（横行，纵行）结构BENEFITINCREASE THE SURFACE FOR BONE / IMPLANT CONTACT BY 15 % 增加骨与假体接触面积15%15%CORAIL 43优选课件Author|PowerP
23、ointtitlegoeshere|AprilXX,2012FEATUREHORIZONTAL MACROSTRUCTURE 横行结构PROGRESSIVE逐渐增大BENEFITTO PREVENT STEMSUBSIDENCE避免假体下沉TO OPTIMISE PROXIMAL LOAD TRANSFER优化近端负荷传导CORAIL 44优选课件Author|PowerPointtitlegoeshere|AprilXX,2012FEATUREVERTICAL MACROSTRUCTURE 纵行结构BENEFITTO IMPROVE ROTATIONAL STABILITY 改善旋转稳定性C
24、ORAIL 45优选课件Author|PowerPointtitlegoeshere|AprilXX,2012FEATUREHYDROXYAPATITE COATING HA涂层BENEFITGREATER SHEAR STRENGTH OF IMPLANT假体的剪力增大INCREASED BONE ONGROWTH增加骨表面增长CORAIL 46优选课件Author|PowerPointtitlegoeshere|AprilXX,2012FEATUREHYDROXYAPATITE COATING HA涂层BENEFITNO FIBROUS TISSUE INTERPOSITION没有纤维组织
25、插入GAP FILLING空隙封闭CORAIL 47优选课件Author|PowerPointtitlegoeshere|AprilXX,2012FEATUREFULL HA COATING完全的HA涂层BENEFITNO THIGH PAIN没有大腿痛BARRIER TO THE INGRESS OF WEAR DEBRIS阻止磨屑进入CORAIL 48优选课件Author|PowerPointtitlegoeshere|AprilXX,2012FEATURE21 YEAR EXPERIENCE21年经验BENEFITOVER 130,000 IMPLANTATIONS假体植入CLINICA
26、L RESULTSCORAIL 49优选课件Author|PowerPointtitlegoeshere|AprilXX,2012FEATURESURGICAL TECHNIQUE外科技术BENEFITEASY & REPRODUCIBLE容易，可重复性强NO CONTRA-INDICATIONS没有禁忌症CORAIL 50优选课件Author|PowerPointtitlegoeshere|AprilXX,2012CORAIL - Positioning 产品定位Keysellingpoints宣传要点SuperiorDesign上乘的设计ProximalLoadingandFullyHAC
27、oated近端负重及HA全涂层21YearsofClinicalHeritage21年的临床验证130000implantationsEasySurgicalTechnique手术技术简单Stemsforallsurgeons满足各种需求PerfectfitforMI适合于MI手术 .51优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Simpleandcomprehensiveinstrumentation 简单易操作的工具CORAIL Surgical technique52优选课件Author|PowerPointtitlegoeshere|
28、AprilXX,2012Simpleprocedure简单的手术步骤Onestepbroaching(nonagressive)一步扩髓腔（不锋利）Nopriorreamingofthecanal不先进行扩髓Preservingcancellousbone保护松质骨Livingbonymantlerespectedandcompacted有活力的松质骨得到重视并压实CORAIL Surgical technique53优选课件Author|PowerPointtitlegoeshere|AprilXX,2012STEP1Neckresectionat4545度颈部截骨Leveldetermin
29、edduringpreopplanning术前计划决定截骨水平CORAIL Surgical technique54优选课件Author|PowerPointtitlegoeshere|AprilXX,2012STEP2Proximalcompactionbeforebroaching锉髓腔前近端松质骨压实Nodistalreaming 远端不扩髓Cancellousboneispreserved保护松质骨CORAIL Surgical technique55优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Canal Finder股骨探髓Canal
30、probeestablishadirectpathwaytothemedullarycanal髓腔探棒找到正确髓腔位置靠后外侧，紧贴梨状窝进入，找到正确髓腔位置，中立位进入，避免内翻56优选课件Author|PowerPointtitlegoeshere|AprilXX,2012STEP3Progressivebroachinguntilcompletestabilityisachieved进行性扩髓直到获得完全的稳定性CORAIL Surgical technique57优选课件Author|PowerPointtitlegoeshere|AprilXX,2012STEP4Calcarmil
31、ling锉平台CORAIL Surgical technique58优选课件Author|PowerPointtitlegoeshere|AprilXX,2012STEP5Trialreductionwithtrialnecksegment试模颈进行试模复位CORAIL Surgical technique59优选课件Author|PowerPointtitlegoeshere|AprilXX,2012STEP6Definitiveimplantinsertion确定的假体插入CORAIL Surgical technique60优选课件Author|PowerPointtitlegoeshe
32、re|AprilXX,2012STEP7Proximalbonecompactionintheremaininggapstoestablishacompletesealbetweenimplant&cortex残留间隙处近端骨压实以建立完全的假体与皮质骨的空隙封闭CORAIL Surgical technique61优选课件Author|PowerPointtitlegoeshere|AprilXX,2012STEP8Femoralheadimpaction股骨头打入CORAIL Surgical technique62优选课件Author|PowerPointtitlegoeshere|Ap
33、rilXX,2012Anteversion 前倾Anteversionbyfirstbroachcontrol前倾角由第一把髓腔锉来控制髓腔锉尽量靠后靠外，避免假体内翻63优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Getting The Correct Implant Size获得正确的假体尺寸Whenthelastbroachisrotationallystable当最后的锉在旋转时取得稳定时建议最后锉打击至截骨面下12mm64优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Avoid earl
34、y impaction避免过早的打压Corail Insertion 假体植入65优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Corail Insertion 假体植入用手将假体沿准备好的髓腔方向推入，避免假体和髓腔错误对线66优选课件Author|PowerPointtitlegoeshere|AprilXX,2012SepcialCase特殊病例67优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Young Male patients年轻男性病人Challenge（挑战）：usuallyyouw
35、illfinditisdifficulttoputthestemin. 通常比较难以将柄植入Reason（原因）：Thisisbecauseyoungmalepatientshavehigherchancefornarrowercanal(especiallyintheconjunctionofmetaphysisanddiaphysisofthefemur).这是由于很多年轻男性病人髓腔比较狭窄（特别是在股骨干骺端连接处）Tips(小技巧）：reamalittlebitatthedistalpartofthenarrowcanaltomakesurewecanchoosearightCora
36、ilimplantthatcanfullyfitinproximalpartofthefemur.在远端髓腔狭窄处用细钻钻一下，确保我们可以选择一个完全匹配股骨近端的正确的假体WecanusetheSrom6/7mmcanalreamertohelpusduringtheoperation.我们可以使用S-Rom工具中的6/7mm的髓腔钻68优选课件Author|PowerPointtitlegoeshere|AprilXX,2012CORAIL CASEREVIEW PRE-OP 9 YEARS2 WEEKS69优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Postoperation Ideal X-ray术后好的X光片 RemainedCancellousBone保留的松质骨70优选课件Author|PowerPointtitlegoeshere|AprilXX,2012CORAIL CASEREVIEWPRE-OP 8 YEARS3 MONTHS 71优选课件Author|PowerPointtitlegoeshere|AprilXX,2012Thank You !72优选课件
