Murray W R
Department of Orthopaedic Surgery, University of California, San Francisco.
Clin Orthop Relat Res. 1990 Feb(251):92-9.
From June 1978 to December 1987, 106 revision total hip arthroplasties (THA) for acetabular salvage were performed using a bipolar device. Bone grafting was necessary in most of the patients. Five patients were unavailable for follow-up examination, leaving 96 patients (101 hips), who were followed for an average of two years 11 months (range, two months to 8.5 years). Excellent or good results were obtained in 43 patients; fair results were achieved in 20 patients. Of the nine patients with poor results, five demonstrated roentgenographic evidence of subluxation, and four showed no roentgenographic changes that could explain their persistent pain. Twenty-nine of these bipolar revisions failed and required reoperation. Fourteen of these failures were revised using fixed, cementless devices in conjunction with bone grafting. Ten patients developed deep-wound infection. Nine were treated successfully; the tenth patient died of overwhelming sepsis, her case complicated by multiple infected joint arthroplasties. While the results of revision THA in the present series are not as satisfactory as those reported by others who used fixed cemented or fixed cementless acetabular components, they are superior to the results obtained with excisional arthroplasty, the only alternative in many of these cases.
1978年6月至1987年12月，使用双极装置对106例髋关节翻修术进行髋臼挽救。大多数患者需要植骨。5例患者无法进行随访检查，剩下96例患者（101髋），平均随访两年11个月（范围为两个月至8.5年）。43例患者获得了优或良的结果；20例患者结果一般。在结果差的9例患者中，5例有半脱位的影像学证据，4例无影像学改变来解释其持续疼痛。这些双极翻修中有29例失败并需要再次手术。其中14例失败使用了固定的非骨水泥装置并联合植骨进行翻修。10例患者发生深部伤口感染。9例成功治愈；第10例患者死于严重脓毒症，其病例合并多处感染性关节置换。虽然本系列髋关节翻修术的结果不如其他使用固定骨水泥或固定非骨水泥髋臼组件者报告的结果令人满意，但优于切除性关节成形术的结果，在许多此类病例中切除性关节成形术是唯一的选择。
