McCarthy Joseph C, Lee Jo-ann
New England Baptist Hospital, Boston, MA 02120, USA.
Clin Orthop Relat Res. 2005 Dec;441:210-5. doi: 10.1097/01.blo.0000194069.15086.1b.
We retrospectively reviewed 39 consecutive hips in 38 patients to examine the outcome of acetabular fixation and stability in patients with the tripolar constrained acetabular component who had complex revision surgery at 2 to 5 years of followup. Preoperative indications included recurrent dislocation, loose acetabular component with instability, migrated bipolar, resection arthroplasty conversions, and primary arthroplasty. Postoperative radiographs were reviewed for radiolucencies, loosening, migration, or breakage. The patients' average age was 65 years (range, 44-83 years). Thirty-five of the 39 acetabular components (91%) are well fixed and bony ingrown. There were no dislocations. One patient was involved in an motor vehicle accident 1 year postoperatively and sustained a fracture of the ilium and a 2 mm radiolucency about the component which is now stable. Three patients had acetabular revisions. Two patients were revised to a tripolar cemented into a cage and are doing well. The tripolar constrained acetabular component offers reliable fixation and joint stability in patients at high risk for dislocation in this short term followup.
Therapeutic study, Level IV (case series). See the Guidelines for Authors for s complete description of levels of evidence.
我们回顾性研究了38例患者的39个连续髋关节,以检查在2至5年随访期内接受复杂翻修手术的三极受限髋臼假体患者的髋臼固定和稳定性结果。术前指征包括复发性脱位、髋臼假体松动伴不稳定、双极假体移位、切除关节成形术转换以及初次关节成形术。对术后X线片进行了评估,以检查是否存在透亮区、松动、移位或断裂。患者的平均年龄为65岁(范围44 - 83岁)。39个髋臼假体中有35个(91%)固定良好且骨长入。无脱位发生。1例患者术后1年发生机动车事故,导致髂骨骨折,假体周围出现2mm透亮区,目前已稳定。3例患者进行了髋臼翻修。2例患者翻修为将三极假体用骨水泥固定于髋臼笼内,情况良好。在这一短期随访中,三极受限髋臼假体为脱位高风险患者提供了可靠的固定和关节稳定性。
治疗性研究,IV级(病例系列)。有关证据水平的完整描述,请参阅作者指南。