Peters Christopher L, Erickson Jill A, Dunn Harold K
Department of Orthopedics, University of Utah, Salt Lake City, 84132, USA.
Clin Orthop Relat Res. 2003 Sep(414):129-35. doi: 10.1097/01.blo.0000079271.91782.6a.
The results of revision of well-fixed Porous Coated Anatomic cementless acetabular components for polyethylene failure or periacetabular osteolysis in 18 hips (14 patients) are reported. Revisions were done with larger diameter cementless acetabular components replacing one-piece Porous Coated Anatomic devices for which no replacement liner was available. The objective was to determine the increase in size of the revision acetabular component and to assess clinical and radiographic outcomes. The Porous Coated Anatomic components were in place for an average of 7.8 years. At an average followup of 68 months, all revision components remain in place. Preoperatively, 12 hips in 10 patients had radiographic osteolysis, and 25 osteolytic lesions in 17 patients were grafted at revision. All grafted lesions showed partial or complete evidence of bone graft consolidation. The average revision component size increased 8.5 mm in diameter (range, 3-14 mm) compared with the primary component size. This corresponded to an average 6.5-mm increase in the acetabular cavitary diameter. When locking mechanism failure in a well-fixed cementless acetabular component prevents polyethylene liner replacement, acetabular component revision can provide good clinical and radiographic results with acceptable bone loss and improved access to osteolytic areas for debridement and grafting.
报道了18例髋关节（14例患者）因聚乙烯磨损或髋臼周围骨溶解而对固定良好的多孔涂层解剖型非骨水泥髋臼假体进行翻修的结果。翻修时采用更大直径的非骨水泥髋臼假体替换一体式多孔涂层解剖型假体，因后者没有可替换的内衬。目的是确定翻修髋臼假体的尺寸增加情况，并评估临床和影像学结果。多孔涂层解剖型假体平均在位7.8年。平均随访68个月时，所有翻修假体均在位。术前，10例患者的12个髋关节存在影像学骨溶解，17例患者的25个溶骨病变在翻修时进行了植骨。所有植骨病变均显示出部分或完全的骨移植融合迹象。与初次假体尺寸相比，翻修假体平均直径增加8.5 mm（范围3 - 14 mm）。这相当于髋臼腔直径平均增加6.5 mm。当固定良好的非骨水泥髋臼假体的锁定机制失效而无法更换聚乙烯内衬时，髋臼假体翻修可提供良好的临床和影像学结果，骨丢失可接受，且便于对溶骨区域进行清创和植骨。
