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用于翻修全髋关节置换术的非骨水泥型大型髋臼杯:对先前报告的简明随访,平均随访20年。

Uncemented jumbo cups for revision total hip arthroplasty: a concise follow-up, at a mean of twenty years, of a previous report.

作者信息

von Roth Philipp, Abdel Matthew P, Harmsen W Scott, Berry Daniel J

机构信息

Department of Orthopedic Surgery, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany. E-mail address:

Department of Orthopedic Surgery, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905. E-mail address for M.P. Abdel:

出版信息

J Bone Joint Surg Am. 2015 Feb 18;97(4):284-7. doi: 10.2106/JBJS.N.00798.

Abstract

Uncemented jumbo cups are commonly used for acetabular revision because they are technically straightforward to implant and provide good intermediate-term results. Understanding long-term survival is particularly important because this method is common and because jumbo cups do not provide notable bone stock restoration. The purpose of the present study was to determine the twenty-year results of jumbo cup use during revision total hip arthroplasty. In the original publication, we reported on eighty-nine patients who underwent revision with an uncemented jumbo cup with a single design (Harris-Galante) prior to 1993. The Harris Hip Score (HHS), radiographic results, and Kaplan-Meier survivorship curves were evaluated. Mean follow-up was twenty years. The mean postoperative HHS was 71 compared with 56 preoperatively (p=0.001). A total of five jumbo cups were revised for aseptic loosening; one, for infection; and one, for recurrent dislocation. Eight liners were revised with retention of the metal acetabular component: six during femoral component revision, one for wear, and one for recurrent dislocations. Twenty-year survivorship was 88% free from aseptic loosening of the metal acetabular component, 85% free from aseptic loosening or radiographic evidence of definite loosening of the metal acetabular component, and 83% free from revision of the metal acetabular component for any reason. The twenty-year results of revision with uncemented jumbo acetabular components demonstrated acceptable clinical outcomes and radiographic stability. These results justify the use of jumbo cups as a common method of acetabular revision.

摘要

非骨水泥型大臼杯常用于髋臼翻修,因为其植入技术简单,且能提供良好的中期效果。了解其长期生存率尤为重要,因为这种方法很常见,而且大臼杯不能显著恢复骨量。本研究的目的是确定在翻修全髋关节置换术中使用大臼杯的20年结果。在最初的报告中,我们报道了1993年前接受单一设计(Harris-Galante)非骨水泥型大臼杯翻修的89例患者。评估了Harris髋关节评分(HHS)、影像学结果和Kaplan-Meier生存曲线。平均随访时间为20年。术后平均HHS为71分,术前为56分(p=0.001)。共有5个大臼杯因无菌性松动进行了翻修;1个因感染;1个因复发性脱位。8个衬垫在保留金属髋臼部件的情况下进行了翻修:6个在股骨部件翻修期间,其中1个因磨损,1个因复发性脱位。金属髋臼部件无菌性松动的20年生存率为88%,无金属髋臼部件无菌性松动或明确松动影像学证据的生存率为85%,因任何原因对金属髋臼部件进行翻修的生存率为83%。非骨水泥型大臼髋臼部件翻修的20年结果显示出可接受的临床结果和影像学稳定性。这些结果证明了使用大臼杯作为髋臼翻修的常用方法是合理的。

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