Charlwood A Philip, Thompson Neville W, Thompson Neill S, Beverland David E, Nixon James R
Orthopaedic Outcomes Unit, Musgrave Park Hospital, Belfast, Northern Ireland.
Acta Orthop Scand. 2002 Oct;73(5):502-5. doi: 10.1080/000164702321022758.
Recurrent posterior dislocation occurs after primary total hip arthroplasty at rates of up to 7%. Component revision is regarded as standard management, but this major surgery may be unsuitable for elderly patients. We have developed a congruent polyethylene acetabular posterior lip augmentation device (PLAD) with a stainless steel backing plate. This can be used when there is no gross malalignment, wear or loosening of the primary components. We retrospectively compared 20 patients who had revision surgery with twenty patients who had been treated with the PLAD for recurrent posterior dislocation after primary Charnley total hip arthroplasty. In the PLAD group, the mean operative time, intraoperative blood loss, time spent in the high-dependency unit (HDU), transfusion requirements and the duration of hospital stay were all less than that in the revision group. There was no difference in the Oxford Hip Score between the groups at latest review 2 years after surgery. None of the patients in either group had suffered another dislocation.
初次全髋关节置换术后复发性后脱位的发生率高达7%。假体翻修被视为标准治疗方法,但这种大手术可能不适用于老年患者。我们研发了一种带有不锈钢背板的全聚乙烯髋臼后唇增强装置(PLAD)。当初次植入部件没有严重排列不齐、磨损或松动时,即可使用该装置。我们回顾性比较了20例行翻修手术的患者与20例在初次Charnley全髋关节置换术后因复发性后脱位接受PLAD治疗的患者。在PLAD组,平均手术时间、术中失血量、在高依赖病房(HDU)的停留时间、输血需求和住院时间均少于翻修组。术后2年的最新评估中,两组之间的牛津髋关节评分没有差异。两组患者均未再次发生脱位。