Marx Axel, Beier Alexander, Richter Anne, Lohmann Christoph H, Halder Andreas M
Sana Kliniken Sommerfeld, Clinic for Orthopaedics, Kremmen - Germany.
Otto-von-Guericke-University Magdeburg, Clinic for Orthopaedics, Magdeburg - Germany.
Hip Int. 2016 Nov 10;26(6):585-590. doi: 10.5301/hipint.5000388. Epub 2016 Sep 20.
Major bone defects are the greatest challenge in hip revision arthroplasty.
In a prospective, consecutive nonrandomised study we followed up 74 patients with Type III (AAOS) acetabular bone defects who underwent revision hip arthroplasty with bone grafting and implantation of a Burch-Schneider anti-protrusion cage (APC). The patients were examined pre- and postoperatively according to a standardised clinical and radiological protocol. No patient was lost to follow-up.
9 patients died before follow-up. In 9 other patients the APC was revised within the follow-up period. In 4 of these patients the revision was necessary because of aseptic loosening. In the remaining 5 cases joint infection, recurrent dislocation and 1 trauma were the reasons for revision. 56 patients were included in the statistical analysis. In the follow-up group the mean Harris Hip Score increased from 39.9 preoperatively to 73.2. 85% of the patients assessed their operation result as good or excellent.
In a large consecutive series the Burch-Schneider anti-protrusion cage proved to be a valuable option in the treatment of major acetabular bone defects in hip revision surgery.
严重骨缺损是髋关节翻修置换术中最大的挑战。
在一项前瞻性、连续非随机研究中，我们对74例患有III型（美国矫形外科医师学会[AAOS]）髋臼骨缺损且接受了髋关节翻修置换术并植骨和植入Burch-Schneider防后凸笼（APC）的患者进行了随访。根据标准化的临床和放射学方案对患者进行术前和术后检查。无患者失访。
9例患者在随访前死亡。另外9例患者在随访期间对APC进行了翻修。其中4例患者因无菌性松动而有必要进行翻修。其余5例中，关节感染、复发性脱位和1例创伤是翻修的原因。56例患者纳入统计分析。随访组中，Harris髋关节评分均值从术前的39.9提高到73.2。85%的患者对手术结果评价为良好或优秀。
在一个大型连续系列研究中，Burch-Schneider防后凸笼被证明是髋关节翻修手术中治疗严重髋臼骨缺损的一个有价值的选择。
