Mäkinen T J, Fichman S G, Watts E, Kuzyk P R T, Safir O A, Gross A E
Mount Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
Bone Joint J. 2016 Jan;98-B(1 Suppl A):73-7. doi: 10.1302/0301-620X.98B1.36307.
An uncemented hemispherical acetabular component is the mainstay of acetabular revision and gives excellent long-term results. Occasionally, the degree of acetabular bone loss means that a hemispherical component will be unstable when sited in the correct anatomical location or there is minimal bleeding host bone left for biological fixation. On these occasions an alternative method of reconstruction has to be used. A major column structural allograft has been shown to restore the deficient bone stock to some degree, but it needs to be off-loaded with a reconstruction cage to prevent collapse of the graft. The use of porous metal augments is a promising method of overcoming some of the problems associated with structural allograft. If the defect is large, the augment needs to be protected by a cage to allow ingrowth to occur. Cup-cage reconstruction is an effective method of treating chronic pelvic discontinuity and large contained or uncontained bone defects. This paper presents the indications, surgical techniques and outcomes of various methods which use acetabular reconstruction cages for revision total hip arthroplasty.
非骨水泥型半球形髋臼假体是髋臼翻修的主要手段，长期效果良好。偶尔，髋臼骨丢失的程度意味着半球形假体置于正确的解剖位置时会不稳定，或者可供生物固定的宿主骨几乎没有出血。在这些情况下，必须采用另一种重建方法。大型柱状结构性同种异体骨已被证明能在一定程度上恢复骨量不足，但需要用重建笼减轻其负荷以防止移植骨塌陷。使用多孔金属增强物是克服与结构性同种异体骨相关的一些问题的一种有前景的方法。如果缺损较大，增强物需要用笼子保护以促进骨长入。杯笼重建是治疗慢性骨盆连续性中断和大型包容性或非包容性骨缺损的有效方法。本文介绍了在全髋关节翻修术中使用髋臼重建笼的各种方法的适应证、手术技术和结果。
