Schmidl S, Jakobs O, Guenther D, Lausmann C, Schoof B, Beckmann J, Gehrke T, Gebauer M
Orthopedic Surgery HELIOS ENDO-Klinik Hamburg, Hamburg, Germany.
Department of Trauma, Hannover Medical School, Hannover, Germany.
Arch Orthop Trauma Surg. 2016 Apr;136(4):579-83. doi: 10.1007/s00402-016-2415-y. Epub 2016 Mar 5.
This retrospective study was performed to determine the effectiveness of preventing recurrent dislocation following primary cemented Endo-MarkIII/SP2 total hip replacement using a posterior lip augmentation device (PLAD).
Between January 2003 and Dezember 2006, 27 PLADs were used in the treatment of recurrent hip dislocation in 27 patients who had received a cemented primary total hip arthroplasty using Endo-MarkIII/SP2 (Waldemar LINK, Hamburg, Germany) components. The mean number of dislocations prior to stabilization with this specific device was 2.6 (range 2-4, SD ± 0.4) with a mean time to revision surgery of 10 months (IQR 13). The mean age of the patients at time of revision surgery was 81.5 years (range 70-94, SD ± 6.9). The control group evaluating the clinical outcome using the Harris Hip Score (HHS) also received a cemented primary total hip arthroplasty using the same implants. A retrospective clinical and radiological review was carried out at a mean follow-up of 68.5 months (range 30-103, SD ± 17.7).
Of the 27 patients, 6 had died at the time of the latest review, with the posterior lip augmentation device still in situ and without reported further dislocation after PLAD application. In 2 of the remaining 21 patients recurrent dislocation occurred, thus a subsequent revision of respective implants had to be performed to achieve persistent joint stability. At latest follow-up no deep infection or implant loosening occurred.
Surgical treatment of recurrent dislocation following primary cemented Endo-MarkIII/SP2 total hip replacement using a posterior lip augmentation device is a safe and effective procedure which can lead to a secondary stabilization of the total hip arthroplasty in about 90 % of the patients.
本回顾性研究旨在确定使用后唇增强装置（PLAD）预防初次骨水泥型Endo-MarkIII/SP2全髋关节置换术后复发性脱位的有效性。
2003年1月至2006年12月期间，27个PLAD用于治疗27例接受了使用Endo-MarkIII/SP2（德国汉堡的Waldemar LINK公司）组件的初次骨水泥型全髋关节置换术的复发性髋关节脱位患者。使用该特定装置稳定脱位前的平均脱位次数为2.6次（范围2 - 4次，标准差±0.4），翻修手术的平均时间为10个月（四分位间距13）。翻修手术时患者的平均年龄为81.5岁（范围70 - 94岁，标准差±6.9）。使用Harris髋关节评分（HHS）评估临床结果的对照组也接受了使用相同植入物的初次骨水泥型全髋关节置换术。在平均随访68.5个月（范围30 - 103个月，标准差±17.7）时进行了回顾性临床和影像学评估。
在27例患者中，6例在最近一次评估时已死亡，后唇增强装置仍在位，且在应用PLAD后未报告进一步脱位。在其余21例患者中的2例发生了复发性脱位，因此必须对相应植入物进行后续翻修以实现持续的关节稳定性。在最近一次随访时未发生深部感染或植入物松动。
使用后唇增强装置对初次骨水泥型Endo-MarkIII/SP2全髋关节置换术后的复发性脱位进行手术治疗是一种安全有效的方法，约90%的患者可实现全髋关节置换术的二次稳定。
