Huang De-Yong, Zhang Liang, Zhou Yi-Xin, Zhang Chun-Yu, Xu Hui, Huang Yong
Department of Orthopedics, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing 100035, China.
Chin Med J (Engl). 2016 Apr 20;129(8):903-8. doi: 10.4103/0366-6999.179793.
Porous-coated cups have been widely used in acetabular reconstruction after failed treatment of acetabular fractures, and good results have been reported with the use of these cups; however, the durability and functionality of modular trabecular metal (TM) acetabular components in acetabular reconstruction after failed treatment of acetabular fractures remain unclear. This study aimed to examine the radiographic and clinical outcomes associated with the use of modular TM acetabular components for failed treatment of acetabular fractures to assess the durability and functionality of these components in acetabular reconstruction after failed treatment of acetabular fractures.
A total of 41 patients (41 hips) underwent total hip arthroplasty (THA) using modular TM acetabular components for failed treatment of acetabular fractures at our hospital between January 2007 and December 2012. Among these patients, two were lost to follow-up. Therefore, 39 patients (39 hips) were finally included in this study. The Harris hip score before and after the surgery, satisfaction level of the patients, and radiographic results were assessed.
The mean Harris hip score increased from 34 (range, 8-52) before surgery to 91 (range, 22-100) at the latest follow-up examination (P < 0.001). The results were excellent for 28 hips, good for six, fair for three, and poor for two. Among the 39 patients, 25 (64%) and 10 (26%) were very satisfied and somewhat satisfied, respectively. All cups were found to be fully incorporated, and no evidence of cup migration or periacetabular osteolysis was noted.
Despite the technically demanding nature of the procedure, THA using modular TM acetabular components showed good durability and functionality and may be an effective reconstruction option for failed treatment of acetabular fractures.
多孔涂层髋臼杯已广泛应用于髋臼骨折治疗失败后的髋臼重建，使用这些髋臼杯已报道有良好的效果；然而，模块化小梁金属（TM）髋臼组件在髋臼骨折治疗失败后的髋臼重建中的耐久性和功能仍不明确。本研究旨在探讨使用模块化TM髋臼组件治疗髋臼骨折失败后的影像学和临床结果，以评估这些组件在髋臼骨折治疗失败后的髋臼重建中的耐久性和功能。
2007年1月至2012年12月期间，我院共有41例患者（41髋）因髋臼骨折治疗失败接受了使用模块化TM髋臼组件的全髋关节置换术（THA）。其中，2例患者失访。因此，最终本研究纳入39例患者（39髋）。评估了手术前后的Harris髋关节评分、患者满意度及影像学结果。
Harris髋关节评分均值从术前的34分（范围8 - 52分）提高到最近一次随访时的91分（范围22 - 100分）（P < 0.001）。结果为优的有28髋，良的有6髋，可的有3髋，差的有2髋。39例患者中，25例（64%）非常满意，10例（26%）有些满意。所有髋臼杯均完全融合，未发现髋臼杯移位或髋臼周围骨溶解的证据。
尽管该手术技术要求较高，但使用模块化TM髋臼组件的THA显示出良好的耐久性和功能，可能是髋臼骨折治疗失败后的一种有效的重建选择。
