Osteoarthritis Treatment Surgical Center, South Marseille Teaching Hospital Center Sainte-Marguerite Hospital, 270, boulevard Sainte-Marguerite, BP 29, 13274 Marseille, France.
Orthop Traumatol Surg Res. 2010 May;96(3):235-41. doi: 10.1016/j.otsr.2009.11.014. Epub 2010 Apr 13.
A number of studies have reported favorable results of cementless fixation in acetabular revisions. Nevertheless, the implant bearing on more than 50% of the patient's bone and good primary stability are required. The objective of this study was to determine whether the use of tantalum implants could provide stable reconstruction for any type of acetabular revision.
This study investigated 72 hips (71 patients) implanted with tantalum cups, some with augments, and morselized graft material. The mean age was 60 years (range, 34-84 years). There were 30 males and 41 females. The mean weight was 71 kg (range, 52-102 kg), the mean height was 1.68 m (range, 1.52-1.84 m). Twenty-five revisions were bipolar. Six revisions were performed for infected acetabular loosening. The mean follow-up was 4 years (range, 2-6 years).
The mean Merle d'Aubigné score at follow-up was 15.8 points (range, 9-18 points). According to the Paprosky classification of acetabular bone defects, there were 13 type 1 (18%), 14 type 2A (19.5%), 14 type 2B (19.4%), 23 type 3A (31.9%), and eight type 3B (11.2%) acetabular defects, four of which had pelvic discontinuity. Postoperatively, the position of the hip's center of rotation in relation to Köhler's teardrop was 22 mm (range, 5-41 mm) vertically (normal, < 25 mm) and 39 mm (range, 13-55 mm) horizontally (normal, < 35 mm). The mean acetabular inclination was 40 degrees (range, 20 degrees -63 degrees ). The radiographic analysis found no radiolucent line after 1 year and up to the last follow-up. None of the patients required revision for acetabular loosening. Three hips were revised for instability. Two retentive liners and a dual-mobility cup were cemented in the cups that were left in place.
Given their mechanical properties (coefficient of friction, porosity), tantalum implants provide a stable primary cementless fixation without compromising the center of rotation and without necessarily requiring a structural graft. A single implant range can therefore be used for any type and severity of bone loss and for all types of acetabular reconstruction. Longer follow-up is nevertheless necessary to confirm these encouraging results.
Level IV, historical series.
许多研究报告称非骨水泥固定在髋臼翻修中具有良好的效果。然而，需要植入物支撑超过 50%的患者的骨和良好的初始稳定性。本研究的目的是确定使用钽植入物是否可以为任何类型的髋臼翻修提供稳定的重建。
本研究调查了 72 髋（71 例）植入钽杯，其中一些使用了增强物和碎骨移植物。平均年龄为 60 岁（范围 34-84 岁）。男性 30 例，女性 41 例。平均体重为 71 公斤（范围 52-102 公斤），平均身高为 1.68 米（范围 1.52-1.84 米）。25 例为双极翻修。6 例为感染性髋臼松动翻修。平均随访时间为 4 年（范围 2-6 年）。
随访时 Merle d'Aubigné 评分平均为 15.8 分（范围 9-18 分）。根据髋臼骨缺损的 Paprosky 分类，13 例为 1 型（18%），14 例为 2A 型（19.5%），14 例为 2B 型（19.4%），23 例为 3A 型（31.9%），8 例为 3B 型（11.2%）髋臼缺损，其中 4 例存在骨盆不连续。术后髋关节旋转中心相对于 Köhler 泪滴的位置为 22 毫米（范围 5-41 毫米）垂直方向（正常<25 毫米）和 39 毫米（范围 13-55 毫米）水平方向（正常<35 毫米）。髋臼平均倾斜度为 40 度（范围 20 度-63 度）。放射学分析显示，在第 1 年和最后一次随访时均未发现透亮线。没有患者因髋臼松动需要翻修。3 髋因不稳定而翻修。在保留的髋臼杯中，有 2 个保持衬垫和 1 个双动杯用水泥固定。
鉴于其机械性能（摩擦系数、孔隙率），钽植入物可提供稳定的非骨水泥初始固定，而不会影响旋转中心，也不一定需要结构性移植物。因此，单一的植入物范围可用于任何类型和严重程度的骨质丢失，以及所有类型的髋臼重建。然而，仍需要更长时间的随访来确认这些令人鼓舞的结果。
IV 级，历史系列。
