Weeden Steven H, Schmidt Robert H
Texas Hip and Knee Center, Fort Worth, Texas, USA.
J Arthroplasty. 2007 Sep;22(6 Suppl 2):151-5. doi: 10.1016/j.arth.2007.04.024. Epub 2007 Jul 27.
Complex acetabular defects are difficult to reconstruct. For severe pelvic defects, tantalum metal acetabular implants may provide a viable solution over traditional implants. This short-term follow-up reviews 43 acetabular revisions treated with tantalum acetabular implants. These revisions included 33 Paprosky type 3A defects, involving 30% to 50% of host acetabulum loss, and 10 type 3B defects, having similar or greater bone loss with a pelvic discontinuity. Tantulum acetabular modular augments were used in 26 cases to support the shell. At a mean of 2.8 years' follow-up, 42 components were stable, and 1 failed because of septic loosening. The overall success rate was 98%. One revision was performed because of loosening secondary to sepsis; none were performed for aseptic loosening. Implants made from highly porous tantalum metal provide a surface that is highly conducive to bone ingrowth. Combined with the ability to use modular augments for added support and stability, this technology may change the way major defects are reconstructed.
复杂髋臼缺损难以重建。对于严重的骨盆缺损,钽金属髋臼植入物可能比传统植入物提供一种可行的解决方案。本短期随访研究了43例采用钽髋臼植入物治疗的髋臼翻修病例。这些翻修包括33例Paprosky 3A 型缺损,累及宿主髋臼骨丢失30%至50%,以及10例3B型缺损,骨丢失相似或更多且伴有骨盆连续性中断。26例使用钽髋臼模块化增强装置来支撑髋臼杯。平均随访2.8年时,42个组件稳定,1个因感染性松动失败。总体成功率为98%。1例因败血症继发松动进行了翻修;无菌性松动未进行翻修。由高度多孔钽金属制成的植入物提供了一个非常有利于骨长入的表面。结合使用模块化增强装置以增加支撑和稳定性的能力,这项技术可能会改变重大缺损的重建方式。