Sembrano Jonathan N, Cheng Edward Y
Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue S, R200, Minneapolis, MN 55454, USA.
Clin Orthop Relat Res. 2008 Jul;466(7):1657-65. doi: 10.1007/s11999-008-0183-x. Epub 2008 Feb 26.
The reported results of acetabular cage reconstruction for pelvic deficiency are widely variable. Our primary question was: what is the survivorship of cage reconstruction with a primary end point of cage revision and secondary end points of radiographic loosening and any reoperation? Secondary questions were: which factors predict cage failure, and what is the functional outcome (SF-36, WOMAC, Harris hip score) of this reconstructive method? We reviewed 72 cage reconstructions in 68 patients. Minimum followup was 1.2 years (mean, 5.1 years; range, 1.2-10.7 years). Five-year cage revision-free survivorship was 87.8%. Five-year loosening-free and acetabular reoperation-free survivorships were 80.7% and 81.3%, respectively. No single preoperative factor (age, gender, severity of pelvic defect, degree of heterotopic ossification, difference in limb lengths and centers of rotation) or intraoperative factor (type of bone graft, type of cage, changes in limb length and center of rotation) predicted cage failure. Functional outcomes were 28.9 (SF-36 Physical Component), 52.4 (SF-36 Mental Component), 33.7 (WOMAC), and 44.2 (Harris). We judged these outcomes acceptable for this sometimes challenging problem. Future techniques for treating pelvic deficiency will need to be compared with these and other outcomes in the literature.
Level IV, therapeutic study.
据报道，髋臼笼重建治疗骨盆缺损的结果差异很大。我们的主要问题是：以髋臼笼翻修为主要终点、影像学松动和再次手术为次要终点时，髋臼笼重建的生存率如何？次要问题是：哪些因素可预测髋臼笼失败，以及这种重建方法的功能结局（SF-36、WOMAC、Harris髋关节评分）如何？我们回顾了68例患者的72次髋臼笼重建。最短随访时间为1.2年（平均5.1年；范围1.2 - 10.7年）。5年无髋臼笼翻修生存率为87.8%。5年无松动和无髋臼再次手术生存率分别为80.7%和81.3%。没有单一的术前因素（年龄、性别、骨盆缺损严重程度、异位骨化程度、肢体长度和旋转中心差异）或术中因素（骨移植类型、髋臼笼类型、肢体长度和旋转中心变化）可预测髋臼笼失败。功能结局为28.9（SF-36身体成分）、52.4（SF-36心理成分）、33.7（WOMAC）和44.2（Harris）。我们认为这些结局对于这个有时具有挑战性的问题来说是可以接受的。未来治疗骨盆缺损的技术需要与文献中的这些及其他结局进行比较。
IV级，治疗性研究。
