Paprosky Wayne G, O'Rourke Michael, Sporer Scott M
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
Clin Orthop Relat Res. 2005 Dec;441:216-20. doi: 10.1097/01.blo.0000194311.20901.f9.
Pelvic discontinuity is encountered frequently during acetabular revision in patients with severe acetabular bone loss. Prompt recognition of the discontinuity and appropriate intraoperative treatment are essential for a successful clinical outcome. The treatment of the discontinuity is dependent on the remaining host bone, the potential for healing of the discontinuity, and the potential for biologic ingrowth of acetabular components. If healing potential of the discontinuity exists, the discontinuity should be treated in compression with a posterior column plate and structural allograft or with the use of trabecular metal acting as an internal plate. If healing potential for the discontinuity does not exist, the discontinuity should be bridged and treated in distraction with an acetabular transplant supported with a cage, a trabecular metal component with trabecular metal augmentation, or with the use of a custom triflange implant.
Therapeutic study, Level III-1 (case-control study). See the Guidelines for Authors for a complete description of levels of evidence.
在严重髋臼骨丢失患者的髋臼翻修术中，骨盆不连续情况经常出现。及时识别不连续情况并进行适当的术中治疗对于获得成功的临床结果至关重要。不连续情况的治疗取决于剩余的宿主骨、不连续处的愈合潜力以及髋臼组件的生物向内生长潜力。如果不连续处存在愈合潜力，应使用后柱钢板和结构性同种异体骨进行加压治疗，或使用小梁金属作为内固定板进行治疗。如果不连续处不存在愈合潜力，则应使用笼子支撑的髋臼移植体、带有小梁金属增强的小梁金属组件或定制的三翼缘植入物进行桥接并在牵引下进行治疗。
治疗性研究，III-1级（病例对照研究）。有关证据水平的完整描述，请参阅作者指南。
