Department of Orthopaedics, The Lahey Clinic, 41 Mall Road, Burlington, MA 01805, USA.
Clin Orthop Relat Res. 2010 Feb;468(2):472-9. doi: 10.1007/s11999-009-1104-3.
Isolated acetabular revision can be associated with variable patient outcomes; there is a risk of hip instability. We evaluated 42 isolated acetabular revision operations and investigated the impact of patient age, diagnosis, bone stock, bone loss, bone augmentation, and obesity on pain and the Harris hip score. Preoperative radiographs were graded according to Paprosky et al. Postoperative radiographs were graded according to Moore et al. and for implant position, prosthetic fixation, and osteolysis. Complications, patient outcome, reoperations, and acetabular rerevisions were recorded. All patients had complete clinical and radiographic followup with a minimum followup of 2 years (mean, 6.4 years; range, 2-13 years). The mean pain score and the mean Harris hip score improved postoperatively. There was one infection 6 months after operation. There were no dislocations. There were three acetabular rerevisions (7%) for aseptic loosening. Patient age, preoperative diagnosis, bone loss, and pelvic bone augmentation had no influence on pain or Harris hip scores. Before operation, obese patients tended to have less pain than nonobese patients but at followup obese patients had less improvement in pain scores than nonobese patients.
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
孤立性髋臼翻修术可能与患者的不同结局相关,存在髋关节不稳定的风险。我们评估了 42 例孤立性髋臼翻修手术,并研究了患者年龄、诊断、骨量、骨量丢失、骨增强和肥胖对疼痛和 Harris 髋关节评分的影响。术前 X 线片根据 Paprosky 等进行分级。术后 X 线片根据 Moore 等进行分级,并评估了假体位置、假体固定和骨溶解情况。记录了并发症、患者结局、翻修手术和髋臼再翻修情况。所有患者均接受了完整的临床和影像学随访,随访时间至少 2 年(平均 6.4 年;范围 2-13 年)。术后疼痛评分和 Harris 髋关节评分均有所改善。术后 6 个月发生 1 例感染。无脱位。因无菌性松动进行了 3 例髋臼再翻修(7%)。患者年龄、术前诊断、骨丢失和骨盆骨增强对疼痛或 Harris 髋关节评分无影响。术前,肥胖患者的疼痛程度低于非肥胖患者,但随访时,肥胖患者的疼痛评分改善程度低于非肥胖患者。
IV 级,治疗性研究。有关证据水平的完整描述,请参见作者指南。