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在髋关节翻修术中使用多孔金属增强物联合骨水泥型或非骨水泥型髋臼杯的可比结果:对147例平均随访5年的翻修病例分析

Comparable Results With Porous Metal Augments in Combination With Either Cemented or Uncemented Cups in Revision Hip Arthroplasty: An Analysis of One Hundred Forty-Seven Revisions at a Mean of Five Years.

作者信息

Mahmoud Ahmed Nageeb, Sundberg Martin, Flivik Gunnar

机构信息

Department of Orthopedics, Skåne University Hospital, Clinical Sciences, Lund University, Lund, Sweden.

出版信息

J Arthroplasty. 2017 May;32(5):1612-1617. doi: 10.1016/j.arth.2016.12.007. Epub 2016 Dec 18.

Abstract

BACKGROUND

Porous metal augments have been used successfully for management of large acetabular defects during revision hip arthroplasty. The purpose of this study was to retrospectively review and compare the clinical and radiographic outcomes of porous metal augments in cemented and uncemented acetabular revisions, all performed at the same institution.

METHODS

Using our institutional clinical databases, the clinical and radiological outcomes of 104 cemented and 43 uncemented acetabular revisions with metal augments, performed between 2006 and 2015, were studied and compared. Acetabular augments were used when preoperative and intraoperative findings indicated the presence of large acetabular defects that can hinder the stability of the revision implants.

RESULTS

At a mean follow-up of 60.1 months (range 12.7-112.1), a total of 5 cups (3.4%), being 3 cemented (2.8%) and 2 uncemented (4.6%), had shown signs of aseptic loosening with cup and augment migration and 4 of these have been re-revised (2.7%). At final follow-up, the European Quality of Life-5 Dimensions for generic health, and the Hip disability and Osteoarthritis Outcome Score (HOOS) parameters had improved substantially without any significant difference between fixation techniques.

CONCLUSION

Porous metal augments show comparable excellent radiographic and clinical mid-term outcomes when combined with cemented or uncemented cups in revision hip arthroplasty.

摘要

背景

多孔金属增强物已成功用于髋关节翻修术中大型髋臼缺损的处理。本研究的目的是回顾性分析并比较在同一机构进行的骨水泥型和非骨水泥型髋臼翻修术中使用多孔金属增强物的临床和影像学结果。

方法

利用我们机构的临床数据库,对2006年至2015年间进行的104例骨水泥型和43例非骨水泥型带金属增强物的髋臼翻修术的临床和放射学结果进行了研究和比较。当术前和术中发现存在可能妨碍翻修植入物稳定性的大型髋臼缺损时,使用髋臼增强物。

结果

平均随访60.1个月(范围12.7 - 112.1个月),共有5个髋臼杯(3.4%)出现无菌性松动迹象,伴有髋臼杯和增强物移位,其中3个为骨水泥型(2.8%),2个为非骨水泥型(4.6%),其中4例进行了再次翻修(2.7%)。在末次随访时,通用健康状况的欧洲生活质量五维度量表以及髋关节残疾和骨关节炎疗效评分(HOOS)参数均有显著改善,固定技术之间无显著差异。

结论

在髋关节翻修术中,多孔金属增强物与骨水泥型或非骨水泥型髋臼杯联合使用时,显示出相当优异的影像学和临床中期结果。

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