翻修全髋关节置换术中模块化双动髋臼组件的疗效
Outcomes of Modular Dual Mobility Acetabular Components in Revision Total Hip Arthroplasty.
作者信息
Sutter E Grant, McClellan Taylor R, Attarian David E, Bolognesi Michael P, Lachiewicz Paul F, Wellman Samuel S
机构信息
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
出版信息
J Arthroplasty. 2017 Sep;32(9S):S220-S224. doi: 10.1016/j.arth.2017.03.035. Epub 2017 Mar 23.
BACKGROUND
There is a high rate of dislocation after revision total hip arthroplasty. This study evaluated the outcomes of 1 modular dual mobility component in revision total hip arthroplasty in patients at high risk of dislocation.
METHODS
We reviewed 64 revisions performed in 27 (42%) patients for recurrent dislocation, 16 (25%) for adverse local tissue reaction, 11 (17%) for reimplantation infection, and 10 (16%) for aseptic loosening, malposition, or fracture. Complications, reoperations, and survivorship were evaluated.
RESULTS
Three-year survival was 98% with failure defined as aseptic loosening and 91% with failure as cup removal for any reason. With mean follow-up time of 38 months, there were 14 complications, including 2 dislocations treated with closed reduction, 9 infections, and 12 reoperations. All complications occurred in patients revised for instability, adverse local tissue reaction, or infection.
CONCLUSION
The early results of this component are promising, with good overall survival and low rate of dislocation.
背景
翻修全髋关节置换术后脱位率较高。本研究评估了一种模块化双动组件在脱位高危患者翻修全髋关节置换术中的疗效。
方法
我们回顾了27例（42%）患者进行的64次翻修手术，其中因复发性脱位进行翻修的有16例（25%），因局部组织不良反应进行翻修的有11例（17%），因再植入感染进行翻修的有10例（16%），因无菌性松动、位置不当或骨折进行翻修的有10例（16%）。对并发症、再次手术和假体生存率进行了评估。
结果
以无菌性松动定义失败时，三年生存率为98%；以任何原因取出髋臼杯定义失败时，三年生存率为91%。平均随访时间为38个月，共出现14例并发症，包括2例通过闭合复位治疗的脱位、9例感染和12例再次手术。所有并发症均发生在因不稳定、局部组织不良反应或感染而进行翻修的患者中。
结论
该组件的早期结果令人鼓舞，总体生存率良好，脱位率低。
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