Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
Clin Orthop Relat Res. 2012 Feb;470(2):395-401. doi: 10.1007/s11999-011-2170-x.
Initial reports with short-term followup of porous tantalum acetabular components and augments for Paprosky IIIA acetabular defects demonstrate high hip scores, low rates of aseptic loosening, and low rates of complications. However, longer-term followup with a larger cohort is needed to determine the durability of these reconstructions.
QUESTIONS/PURPOSES: We therefore determined the functional scores, rates of aseptic loosening, and complications in patients with Paprosky IIIA acetabular defects treated with porous tantalum acetabular components and augments.
We retrospectively reviewed 37 acetabular revisions in 36 patients (one patient with bilateral revisions) treated with a porous tantalum acetabular component and augment. All patients had defects classified as Type IIIa using the system of Paprosky et al. Harris hip scores were obtained and radiographic examination was performed before surgery and through most recent followup. The minimum followup was 26 months (mean, 60 months; range, 26-106 months).
One patient developed aseptic loosening of the acetabular reconstruction requiring revision; seven other patients required further surgery for periprosthetic femoral fracture (two), acute infection (three), and recurrent dislocation (two). Thirty-five of 37 hips had no or occasional pain at final followup. Mean Harris hip scores improved from 33.0 preoperatively (range, 12.6-58.7) to 81.5 postoperatively (range, 27.0-99.8).
Although the complication rate requiring further surgery was considerable, most patients with these reconstructions had pain relief and reasonable function with low rates of loosening at midterm followup.
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
带有短期随访的多孔钽髋臼组件和 Paprosky IIIA 髋臼缺损补块的初始报告表明，髋关节评分高、无菌性松动率低、并发症发生率低。然而，需要更长时间的随访和更大的队列来确定这些重建的耐久性。
问题/目的：因此，我们确定了使用多孔钽髋臼组件和补块治疗 Paprosky IIIA 髋臼缺损的患者的功能评分、无菌性松动率和并发症。
我们回顾性分析了 36 名患者（1 名患者双侧翻修）的 37 例髋臼翻修，使用多孔钽髋臼组件和补块。所有患者的髋臼缺损均采用 Paprosky 等人的系统分类为 IIIa 型。术前、末次随访时均行 Harris 髋关节评分和影像学检查。随访时间至少 26 个月（平均 60 个月；范围 26-106 个月）。
1 例髋臼重建发生无菌性松动，需要翻修；7 例其他患者因股骨假体周围骨折（2 例）、急性感染（3 例）和复发性脱位（2 例）需要进一步手术。37 髋中有 35 髋在末次随访时无或偶有疼痛。术前平均 Harris 髋关节评分为 33.0（范围 12.6-58.7），术后为 81.5（范围 27.0-99.8）。
尽管需要进一步手术的并发症发生率相当高，但大多数接受这些重建的患者在中期随访时疼痛缓解，功能合理，松动率低。
IV 级，治疗研究。有关证据水平的完整描述，请参见作者指南。
