采用定制三叶形补片治疗骨盆不连续性：一种可靠的选择。
Pelvic discontinuity treated with custom triflange component: a reliable option.
机构信息
Department of Orthopedic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA.
出版信息
Clin Orthop Relat Res. 2012 Feb;470(2):428-34. doi: 10.1007/s11999-011-2126-1.
BACKGROUND
Pelvic discontinuity is an increasingly common complication of THA. Treatments of this complex situation are varied, including cup-cage constructs, acetabular allografts with plating, pelvic distraction technique, and custom triflange acetabular components. It is unclear whether any of these offer substantial advantages.
QUESTIONS/PURPOSES: We therefore determined (1) revision and overall survival rates, (2) discontinuity healing rate, and (3) Harris hip score (HHS) after treatment of pelvic discontinuity with a custom triflange acetabular component and (4) the cost of this reconstructive operation compared to other constructs.
METHODS
We retrospectively reviewed 57 patients with pelvic discontinuity treated with revision THA using a custom triflange acetabular component. We reviewed operative reports, radiographs, and clinical data for clinical and radiographic results. We also performed a cost comparison with utilization of other techniques. Minimum followup was 24 months (average, 65 months; range, 24-215 months).
RESULTS
Fifty-six of 57 (98%) were free of revision for aseptic loosening at latest followup. Fifty-four (95%) were free of revision of the triflange component for any reason. Thirty-seven (65%) were free of revision for any reason. Twenty-eight (49%) were free of revision for any reason and free of any component migration and had a healed discontinuity. Forty-six (81%) had a stable triflange component with a healed pelvic discontinuity. Average HHS was 74.8. The costs of the custom triflange implants and a Trabecular Metal cup-cage construct were equivalent: $12,500 and $11,250, respectively.
CONCLUSIONS
In this group of patients with osteolytic pelvic discontinuity, triflange implants provided predictable mid-term fixation at a cost equivalent to other treatment methods.
LEVEL OF EVIDENCE
Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
背景
骨盆不连续性是 THA 越来越常见的并发症。这种复杂情况的治疗方法多种多样，包括杯笼结构、带板的髋臼同种异体移植物、骨盆分离技术和定制 triflange 髋臼组件。目前尚不清楚这些方法中是否有任何一种具有明显优势。
问题/目的：因此，我们确定了（1）翻修和总体生存率，（2）不连续性愈合率，（3）使用定制 triflange 髋臼组件治疗骨盆不连续性后的 Harris 髋关节评分（HHS），以及（4）与其他结构相比，这种重建手术的成本。
方法
我们回顾性分析了 57 例采用定制 triflange 髋臼组件治疗的骨盆不连续性翻修 THA 患者。我们回顾了手术报告、影像学资料和临床数据，以评估临床和影像学结果。我们还对使用其他技术的成本进行了比较。最低随访时间为 24 个月（平均 65 个月；范围 24-215 个月）。
结果
57 例患者中有 56 例（98%）在末次随访时无无菌性松动翻修。54 例（95%）无 triflange 组件因任何原因翻修。37 例（65%）无任何原因翻修。28 例（49%）无任何原因翻修，无任何组件迁移且骨盆不连续性愈合。46 例（81%）具有稳定的 triflange 组件和愈合的骨盆不连续性。平均 HHS 为 74.8。定制 triflange 植入物和 Trabecular Metal 杯笼结构的成本相当：分别为 12500 美元和 11250 美元。
结论
在这组患有溶骨性骨盆不连续性的患者中，triflange 植入物提供了可预测的中期固定，成本与其他治疗方法相当。
证据水平
IV 级，治疗研究。有关证据水平的完整描述，请参阅作者指南。
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