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使用纵向椭圆形翻修髋臼杯治疗III型和IV型髋臼缺损

Management of types III and IV acetabular deficiencies with the longitudinal oblong revision cup.

作者信息

Herrera Antonio, Martínez Angel Antonio, Cuenca Jorge, Canales Vicente

机构信息

Service of Orthopedic and Trauma Surgery, Miguel Servet University Hospital, Zaragoza, Spain.

出版信息

J Arthroplasty. 2006 Sep;21(6):857-64. doi: 10.1016/j.arth.2005.08.026.

Abstract

Thirty-five longitudinal oblong revision (LOR) cups were used to reconstruct 29 type III and 6 type IV acetabular defects. Intraoperatively, we considered that cup contact was complete when we achieved a continuous contact between the cup periphery and the acetabular rim. When there were areas with a lack of contact, we considered that the contact was partial or incomplete. All patients were followed up for 4 to 8 years (mean = 6.3 years). At the latest follow-up, 30 cups were stable (85.8%) and 5 had migrated (14.2%). We found a significant relation between incomplete cup contact with the acetabular rim and subsequent failure (P = .042). The abduction angle was significantly increased in the group of unstable cups (P = .032) because of the migration of the acetabular component that became more vertical. Pain, limp, use of walking aids, functional level, and limb-length discrepancy significantly improved postoperatively (P < .0001). The Harris hip score improved from a mean preoperative score of 37 points to that of 79 points (P < .01). This implant showed satisfactory stability at early to midterm follow-up.

摘要

使用35个纵向椭圆形翻修(LOR)杯来重建29例III型和6例IV型髋臼缺损。术中,当杯体周边与髋臼边缘实现连续接触时,我们认为杯体接触完整。当存在接触缺失区域时,我们认为接触是部分的或不完整的。所有患者均随访4至8年(平均 = 6.3年)。在最新随访时,30个杯体稳定(85.8%),5个发生了移位(14.2%)。我们发现杯体与髋臼边缘接触不完整与随后的失败之间存在显著关联(P = .042)。由于髋臼组件移位变得更加垂直,不稳定杯体组的外展角度显著增加(P = .032)。术后疼痛、跛行、助行器使用、功能水平和肢体长度差异均有显著改善(P < .0001)。Harris髋关节评分从术前平均37分提高到79分(P < .01)。该植入物在早期至中期随访中显示出令人满意的稳定性。

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