坎贝尔骨科手术学（套装共4卷）

章节摘录

版权页：   插图：   The clinical experience with metal-on-metal hip arthroplasty now exceeds 40 years. Although some implants have survived with a remarkably low wear rate, others have failed because of flawed materials selection, poor manufacturing tolerances,inadequate clearance between implants, and impingement.Autopsy retrieval of implants that have survived long term has been invaluable in determining desirable features for a new generation of these implants. High-carbon (>0.20% carbon) cobalt-chromium alloy has been demonstrated to have lower wear rates than low-carbon alloys. After investment casting of high-carbon cobalt-chromium alloy, large blocky carbides are precipitated throughout the metal matrix. These carbides are approxi-mately five times harder than the metallic matrix, approximately the same as alumina ceramic. A high carbide content confers wear resistance on a metal-on-metal articulation and is a desirable feature. Wrought material has a smaller grain size with a fine, homogenous distribution of carbides. Diarnetral clearance refers to the gap between the two implants at the equator of the articulation and may be the most important variable affecting wear of the couple. Smaller clearances tend to produce fluid film lubrication and reduced wear. Inadequate clearance leads to equatorial contact between the implants, however, and the resulting high frictional torque may be responsible for the high loosening rate seen with some earlier-generation metal-on-metal implants. Conversely, too large a clearance leads to reduced surface contact, loss of effective lubrication, and more rapid wear.Current implants promote primarily polar contact with a clearance in the range of 100 to 200 μm, depending on the diameter of the head. With a monoblock metal acetabular component, elastic deformation occurring during implantation can reduce clearance. This couple also has been described as "self-healing" because minor surface damage may be polished smooth over time. Hip simulator data and retrieval analysis have yielded combined wear rates less than 10 μm/yr for modern metal-on-metal articulations. Large-diameter heads (54 mm) have been associated with reduced wear. The particle size is much smaller than polyethylene, however, and the number of partides is larger. Patients with metal-on-metal hip replacements have elevated levels of cobalt and chromium ions in serum, erythrocytes, and urine compared with patients with metal-on-polyethylene arthroplasties. The methods for measurement of these ion levels are complex, and there are no uniform standards for reporting. The long-term exposure to these ionsraises concerns of malignancies. In a long-term follow-up of 579 patients with metal-on-metal total hip replacements,Visuri et al. found no increase in cancer rates. A substantially larger series would be required to have the statistical power to rule out such an association, but at present there is no causal link between elevated metal ion levels and the development of malignancies.

名人推荐

最新英文原版影印，零距离领略巨著风采，全球最负盛名的骨科学圣经，由世界级专家联袂编撰，骨科医生口口相传的案头必备工具书。

媒体关注与评论

一、出版时间紧随原著：《坎贝尔骨科手术学》第12版的英文原版于2012年12月新近出版，影印版几乎在第一时间同步推出，使中国读者得以率先领略原著风采。二、专业英语原汁原味：《坎贝尔骨科手术学》第12版对于刚开始从事骨科工作的低年资住院医生、年资较高的骨科专家及广大医学院校师生均为一部值得深入研读的高级参考书，影印版更可作为学习专业英语的最佳读物。三、影印版保证高品质：影印版全铜版纸印刷，品质绝不打折。12版图片更为精致，准确传达各类手术细节和要点。四、最新进展完美呈现：第12版全面进行知识更新，介绍骨科近5年的新技术、新装备，如全髋及全膝关节置换微创入路、骨折固定术的小截面植入物、脊柱手术新设备，深入探讨新型骨移植材料，以及关节镜和内镜技术等。

内容概要

S·泰瑞·卡奈尔（S. Terry Canale），医学博士，教授。美国著名骨科学专家，坎贝尔骨科医院，田纳西大学骨外科学系主席。詹姆斯·H·贝蒂（James H. Beaty），医学博士，教授。美国著名骨科学专家，坎贝尔骨科医院，田纳西大学骨外科学系主任。

书籍目录

《坎贝尔骨科手术学（影印版·第12版）1》目录： VOLUMEⅠ PART 1  GENERAL PRINCIPLES 1 Surgical Techniques and Approaches Andrew H. Crenshaw, Jr. 2 Magnetic Resonance Imaging in Orthopaedics Dexter H. Witte PART2 RECONSTRUCTIVE PROCEDURES OF THE HIP IN ADULTS 3 Arthroplasty of the Hip James W. Harkess and John R. Crockarell, Jr. 4 Hip Resurfacing David G. Lavelle 5 Arthrodesis of the Hip William E. Albers 6 Hip Pain in the Young Adult and Hip Preservation Surgery James L. Guyton PERT3 RECONSTRUCTIVE PROCEDURES OF THE KNEE IN ADULTS 7 Arthroplasty of the Knee William M. Mihalko 8 Arthrodesis of the Knee William E. Albers 9 Soft Tissue Procedures and Corrective Osteotomies about the Knee Andrew H, Crenshaw, Jr. PERT 4 RECONSTRUCTIVE PROCEDURES OF THE ANKLE IN ADULTS 10 Total Ankle Arthroplasty G. Andrew Murphy 11 Ankle Arthrodesis G. Andrew Murphy PERT 5 RECONSTRUCTIVE PROCEDURES OF THE SHOULDER AND ELBOW IN ADULTS 12 Shoulder and Elbow Arthroplasty Thomas W. Throckmorton 13 Arthrodesis of the Shoulder and Elbow Thomas W. Throckmorton PERT6 AMPUTATIONS 14 General Principles of Amputations Patrick C. Toy 15 Amputations of the Foot David R. Richardson 16 Amputations of the Lower Extremity Marc J. Mihalko 17 Amputations of the Hip and Pelvis Marc J. Mihalko 18 Amputations of the Upper Extremity Kevin B. Cleveland 19 Amputations of the Hand James H. Calandruccio PART 7 NFETIONS 20 General Principles of Infection Kevin B. Cleveland 21 Osteomyelitis Gregory D. Dabov 22 Infectious Arthritis Anthony A. Mascioli and Ashley L Park 23 Tuberculosis and Other Unusual Infections Marc J. Mihalko …… VOLUMEⅡ VOLUMEⅢ VOLUMEⅣ …… 《坎贝尔骨科手术学（影印版·第12版）2》 《坎贝尔骨科手术学（影印版·第12版）3》 《坎贝尔骨科手术学（影印版·第12版）4》 《实用骨折治疗指南》

编辑推荐

《坎贝尔骨科手术学》第12版的英文原版于2012年12月新近出版，影印版几乎在第一时间同步推出，使中国读者得以率先领略原著风采。《坎贝尔骨科手术学》影印版采取全铜版纸印刷，保持原版书品质，更可作为学习专业英语的最佳读物。《坎贝尔骨科手术学》第12版在约4600页的篇幅内介绍了1630种手术操作，涵盖7000余幅图片，包括大量重新绘制的示意图、影像诊断图片、临床手术实景照片等。第12版调整大量编排结构，全面进行知识更新，介绍骨科近5年的新技术、新装备。多年以来，《坎贝尔骨科手术学》在骨科图书中一枝独秀，伴随了一代又一代骨科医师的成长。《坎贝尔骨科手术学》首版于1939年。此后每5至7年，《坎贝尔骨科手术学》由坎贝尔骨科诊所专家进行一次全面更新修订。全球骨科医师提及《坎贝尔骨科手术学》时，均将其比喻为骨科学领域的圣经。

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