Gross Allan E
Division of Orthopaedic surgery, Faculty of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
J Arthroplasty. 2006 Jun;21(4 Suppl 1):117-20. doi: 10.1016/j.arth.2005.11.006.
The surgical strategy for revision of the acetabular component is determined by available host bone stock. Contained (cavitary) bone loss is the most common pattern of bone loss and can be addressed by morsellized bone graft. If contact can be made with at least 50% host bone, conventional uncemented cups can be used. If, however, contact with 50% host bone cannot be achieved, a protective cage and a cemented cup is an acceptable option but with a significant complication rate. The use of trabecular metal, which provides a more favorable environment for bone graft remodeling and host bone ingrowth, has allowed us to address larger contained defects without resorting to a cage. For massive contained defects, a combination of a trabecular metal cup protected by a cage has been used.
髋臼部件翻修的手术策略取决于可用的宿主骨量。包容性(空洞性)骨缺损是最常见的骨缺损模式,可通过颗粒状骨移植来解决。如果能与至少50%的宿主骨接触,可使用传统的非骨水泥髋臼杯。然而,如果无法与50%的宿主骨接触,使用保护性髋臼笼和骨水泥髋臼杯是一种可接受的选择,但并发症发生率较高。使用小梁金属可为骨移植重塑和宿主骨长入提供更有利的环境,使我们能够处理更大的包容性骨缺损而无需使用髋臼笼。对于大面积包容性骨缺损,已采用在髋臼笼保护下使用小梁金属髋臼杯的联合方法。