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模块化多孔金属增强物用于髋关节翻修术中严重髋臼骨缺损的治疗。

Modular porous metal augments for treatment of severe acetabular bone loss during revision hip arthroplasty.

作者信息

Nehme Alexandre, Lewallen David G, Hanssen Arlen D

机构信息

Department of Orthopedics, Mayo Clinic and Mayo Foundation, 200 First Street Southwest, Rochester, MN 55906, USA.

出版信息

Clin Orthop Relat Res. 2004 Dec(429):201-8. doi: 10.1097/01.blo.0000150133.88271.80.

Abstract

Modular acetabular augments were implanted in 16 patients (16 hips) for support of an uncemented hemispheric acetabular component during revision acetabular reconstruction. Based on the classification of Paprosky, acetabular bone defects were classified as 2A in one hip, 2B in three hips, 2C in one hip, 3A in five hips, and 3B in six hips. Preoperatively, the prosthetic femoral head centers were located at a mean horizontal distance of 18.6 mm (range, -3-46 mm), and a mean vertical distance of 27.6 mm (range, -16-52 mm) from the approximate femoral head center. Postoperatively, the prosthetic femoral head centers were located at a mean horizontal distance of 10.4 mm (range, 1-25 mm), and a mean vertical distance of 7.4 mm (range, -15-25 mm). At final followup, no implant had evidence of migration or loosening. At early clinical followup, this modular acetabular augment system seems helpful in acetabular reconstructions that cannot be treated with an uncemented hemispheric cup that would have required other forms of treatment such as structural allografts, acetabular cages, bilobed acetabular components, or custom acetabular components. Longer term followup is required to determine whether there are untoward effects of using a modular acetabular reconstructive system.

摘要

在髋臼翻修重建过程中,为支持非骨水泥半球形髋臼假体,对16例患者(16髋)植入了模块化髋臼增强装置。根据Paprosky分类,髋臼骨缺损在1髋中被分类为2A,3髋中为2B,1髋中为2C,5髋中为3A,6髋中为3B。术前,假体股骨头中心距大致股骨头中心的平均水平距离为18.6 mm(范围为-3至46 mm),平均垂直距离为27.6 mm(范围为-16至52 mm)。术后,假体股骨头中心距大致股骨头中心的平均水平距离为10.4 mm(范围为1至25 mm),平均垂直距离为7.4 mm(范围为-15至25 mm)。在最终随访时,没有植入物有移位或松动的迹象。在早期临床随访中,这种模块化髋臼增强系统似乎有助于髋臼重建,这些重建无法用非骨水泥半球形髋臼杯治疗,而后者可能需要其他形式的治疗,如结构性同种异体骨、髋臼笼、双叶髋臼假体或定制髋臼假体。需要更长时间的随访来确定使用模块化髋臼重建系统是否有不良影响。

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