Coscujuela-Mañá Antonio, Angles Francesc, Tramunt Carles, Casanova Xavier
Department of Orthopaedic Surgery and Trauma, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
Hip Int. 2010;20 Suppl 7:S112-8. doi: 10.1177/11207000100200s719. Epub 2010 May 27.
Ninety-six acetabular revisions using a Burch-Schneider antiprotrusio cage (BSAC) in 91 patients (53 women and 38 men), were evaluated retrospectively with a mean follow-up of 8.1 years (range 5-13 years). The mean age at surgery was 67.3 years (range 35-85 years). There were 3 re-revisions: 1 because of aseptical loosening and 2 because of deep infection. The Kaplan-Meier survivorship rate, with aseptic component loosening as the criterion of failure, was 92.4% (95% confidence interval, 85.1%-99.8%) at 13 years. Clinical evaluation of the surviving patients showed an increase in mean Merle d?Aubigné-Postel hip score of 8.8 points before surgery, to 15.1 points at the time of the last follow-up. Radiographic evaluation determined that 3 cages were considered definitely loose. The rotation centre of the hip was lowered an average of 4.3 mm and lateralised an average of 1.3 mm in this series. In the most severe cases (Paprosky 2C, 3A, and 3B), the hip centre was lowered 7.8 mm and lateralised 0.8 mm. The Burch-Schneider antiprotrusio cage long-term survival rate compares favourably with that for other devices. Acetabular reconstruction allows anatomic positioning of the cups and promotes good final results.
对91例患者(53例女性和38例男性)使用Burch-Schneider防髋臼突出笼(BSAC)进行的96例髋臼翻修手术进行了回顾性评估,平均随访8.1年(范围5 - 13年)。手术时的平均年龄为67.3岁(范围35 - 85岁)。有3例再次翻修:1例因无菌性松动,2例因深部感染。以无菌性假体松动作为失败标准,13年时的Kaplan-Meier生存率为92.4%(95%置信区间,85.1% - 99.8%)。对存活患者的临床评估显示,平均Merle d’Aubigné-Postel髋关节评分从术前的8.8分提高到最后一次随访时的15.1分。影像学评估确定3个笼被认为明显松动。在本系列中,髋关节旋转中心平均降低4.3 mm,平均向外移位1.3 mm。在最严重的病例(Paprosky 2C、3A和3B)中,髋关节中心降低7.8 mm,向外移位0.8 mm。Burch-Schneider防髋臼突出笼的长期生存率与其他器械相比具有优势。髋臼重建可使髋臼杯进行解剖定位并促进良好的最终结果。