Rady Ahmad Emad, Asal Mohammed Kamal, Bassiony Ayman Abdelaziz
Ain Shams University, Cairo, Egypt.
Hip Int. 2010 Oct-Dec;20(4):434-9. doi: 10.1177/112070001002000404.
Recurrent dislocation after total hip arthroplasty is a disabling complication that can be difficult to treat. We evaluated the early clinical and radiographic outcome associated with the use of a constrained acetabular component for instability in total hip arthroplasty. Fifteen patients underwent either primary or revision total hip arthroplasty with a cementless constrained acetabular component for different indications. The mean patient age at surgery was 57.4 years and the mean clinical and radiological follow-up period was 26.4 months. Clinical assessment was performed by the Harris hip score and at the latest follow up patients reported outcome using the Oxford hip score questionnaire. All radiographs were evaluated for evidence of loosening. Only one patient experienced redislocation with the constrained prosthesis. The average Harris hip score increased from a preoperative mean of 22 (range, 16 - 36) to a postoperative mean of 85 (range, 66-94). Preoperatively, the mean Oxford Hip Score was 48.6, which decreased to 20.5 at the final examination. All but one of the 15 hips had a well-fixed, stable cup. Femoral component stability with bone ingrowth was achieved in 10 cases. A constrained acetabular component is an effective option for the treatment of hip instability in primary and revision arthroplasty in those at high risk of dislocation. The potential for aseptic loosening requires evaluation by long term studies.
全髋关节置换术后复发性脱位是一种致残性并发症，治疗可能较为困难。我们评估了在全髋关节置换术中使用限制性髋臼组件治疗不稳定相关的早期临床和影像学结果。15例患者因不同适应证接受了初次或翻修全髋关节置换术，使用了非骨水泥型限制性髋臼组件。手术时患者的平均年龄为57.4岁，临床和影像学平均随访期为26.4个月。通过Harris髋关节评分进行临床评估，在最近一次随访时，患者使用牛津髋关节评分问卷报告结果。对所有X线片进行松动证据评估。使用限制性假体的患者中只有1例出现再脱位。Harris髋关节评分平均从术前的22分（范围16 - 36分）提高到术后的85分（范围66 - 94分）。术前，牛津髋关节评分平均为48.6分，在最后检查时降至20.5分。15个髋关节中除1个外，其余均有固定良好、稳定的髋臼杯。10例实现了股骨组件与骨长入的稳定性。对于初次和翻修关节成形术中脱位高危患者，限制性髋臼组件是治疗髋关节不稳定的有效选择。无菌性松动的可能性需要通过长期研究进行评估。
