Šťastný Eduard, Trč Tomáš, Handl Milan, Kos Petr, Kautzner Jakub, Philippou Theodoros, Lisý Jiří
Department of Paediatric and Adult Orthopaedic Surgery and Traumatology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Úvalu 84, Prague 5, 154 00, Czech Republic,
Int Orthop. 2014 May;38(5):935-40. doi: 10.1007/s00264-013-2269-7. Epub 2014 Jan 16.
The aim of the present study was to introduce a novel oblong revision cup type TC for use in revision total hip arthroplasty (THA), and to evaluate mid-term results in terms of bone tissue remodelling in the immediate area of the implant.
The results of 31 patients that underwent revision THA between 2004 and 2008 are presented. The mean follow-up interval was 7.1 years (range 5.3-9.3 years, minimum of five years following revision). Osteointegration of the implant and bone tissue remodelling around the implant and ribs were assessed by X-ray and computed tomography (CT).
The average Harris hip score increased from 39.8 to 85.3. Excellent results were achieved in nine patients, good in 16, fair in three and poor in three. According to X-ray results, 25 hips had a well-fixed, bone-ingrown cup and five had a stable fibrous union in the middle and the distal third of the implant. Proximal migration of the cup was noted in one case. Pelvic CT was additionally performed in ten patients. In all cases, we detected bone remodelling in the space between the implant ribs. Kaplan-Maier survivorship of the acetabular components was 94.2 % at 7.1 years.
Our results show that the novel oblong revision cup type TC is relatively simple to implant, and is associated with reliable primary fixation and documented osteointegration and bone remodelling in the immediate area.
本研究的目的是引入一种新型长方形翻修杯型TC，用于翻修全髋关节置换术（THA），并评估植入物附近区域骨组织重塑方面的中期结果。
介绍了2004年至2008年间接受翻修THA的31例患者的结果。平均随访间隔为7.1年（范围5.3 - 9.3年，翻修后至少五年）。通过X射线和计算机断层扫描（CT）评估植入物的骨整合以及植入物和肋骨周围的骨组织重塑。
Harris髋关节平均评分从39.8提高到85.3。9例患者结果优秀，16例良好，3例尚可，3例较差。根据X射线结果，25个股骨有固定良好、骨长入的髋臼杯，5个股骨在植入物中部和远端三分之一处有稳定的纤维性愈合。1例出现髋臼杯近端移位。另外对10例患者进行了骨盆CT检查。在所有病例中，我们在植入物肋骨之间的间隙中检测到骨重塑。髋臼组件在7.1年时的Kaplan - Meier生存率为94.2%。
我们的结果表明，新型长方形翻修杯型TC植入相对简单，与可靠的初次固定相关，并且在附近区域有记录的骨整合和骨重塑。
