Jo Woo-Lam, Lim Young-Wook, Im Jin-Hyung, Kim Seung-Chan, Kwon Soon-Yong, Kim Yong-Sik
Department of Orthopaedic Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
Department of Orthopaedic Surgery, Gyeongsang National University Changwon Hospital, Changwon, Korea.
Hip Pelvis. 2017 Mar;29(1):24-29. doi: 10.5371/hp.2017.29.1.24. Epub 2017 Mar 6.
It is challenging procedure to revise acetabular component in acetabulum with severe bone defect or deformity. The jumbo cup is good option for revisional arthroplasty in large bone defect. The purpose of this study is to compare the prognosis of revisional total hip arthroplasty using jumbo cup with peripheral rim fixation and no rim fixation.
We included the patients who had performed acetabular revisional total hip arthroplasty from January 2002 to March 2015 in our institute. Total of 51 hips (51 patients) were included. The mean follow up period was 51 months (range, 12 to 154 months) and mean age was 60.7 years (range, 30 to 81 years). We divided into two groups (peripheral rim fixation group and no rim fixation group) by anteroposterior and lateral plain radiograph. We compared survival rate, hip center change and clinical outcomes between two groups.
There were 37 patients in peripheral rim fixation group and 14 patients in no rim fixation group. There was one patient who had aseptic loosening necessary to re-revision in rim fixation group and 3 patients in no rim fixation group. And one patient had superficial infection in rim fixation group and one patient had periprosthetic fracture in no rim fixation group. Survival rate was higher in the peripheral rim fixation group (97.3%) than no rim fixation group (78.6%, =0.028).
Based on our findings, peripheral rim fixation might be recommended to improve short-term outcome after revision total hip arthroplasty using jumbo cup.
在髋臼存在严重骨缺损或畸形的情况下，翻修髋臼假体是一项具有挑战性的手术。超大臼杯是大骨缺损翻修关节成形术的一个不错选择。本研究的目的是比较使用带周边边缘固定和不带边缘固定的超大臼杯进行全髋关节翻修术的预后。
我们纳入了2002年1月至2015年3月在我院接受髋臼翻修全髋关节置换术的患者。共纳入51例髋关节（51例患者）。平均随访时间为51个月（范围12至154个月），平均年龄为60.7岁（范围30至81岁）。通过前后位和侧位X线平片将患者分为两组（周边边缘固定组和无边缘固定组）。我们比较了两组之间的生存率、髋关节中心变化和临床结果。
周边边缘固定组有37例患者，无边缘固定组有14例患者。边缘固定组有1例患者发生无菌性松动需要再次翻修，无边缘固定组有3例。边缘固定组有1例患者发生表浅感染，无边缘固定组有1例患者发生假体周围骨折。周边边缘固定组的生存率（97.3%）高于无边缘固定组（78.6%，P = 0.028）。
基于我们的研究结果，对于使用超大臼杯进行全髋关节翻修术后改善短期疗效而言，可能推荐采用周边边缘固定。
