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用于严重髋臼缺损患者翻修全髋关节置换术的定制三翼髋臼植入物:规划、植入及结果

The patient-specific Triflange acetabular implant for revision total hip arthroplasty in patients with severe acetabular defects: planning, implantation, and results.

作者信息

Berend M E, Berend K R, Lombardi A V, Cates H, Faris P

机构信息

Midwest Center for Joint Replacement, Indianapolis, Indiana, USA.

Joint Implant Surgeons, New Albany, Ohio, USA.

出版信息

Bone Joint J. 2018 Jan;100-B(1 Supple A):50-54. doi: 10.1302/0301-620X.100B1.BJJ-2017-0362.R1.

DOI:10.1302/0301-620X.100B1.BJJ-2017-0362.R1
PMID:29292340
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6424441/
Abstract

AIMS

Few reconstructive techniques are available for patients requiring complex acetabular revisions such as those involving Paprosky type 2C, 3A and 3B deficiencies and pelvic discontinuity. Our aim was to describe the development of the patient specific Triflange acetabular component for use in these patients, the surgical technique and mid-term results. We include a description of the pre-operative CT scanning, the construction of a model, operative planning, and surgical technique. All implants were coated with porous plasma spray and hydroxyapatite if desired.

PATIENTS AND METHODS

A multicentre, retrospective review of 95 complex acetabular reconstructions in 94 patients was performed. A total of 61 (64.2%) were female. The mean age of the patients was 66 (38 to 85). The mean body mass index was 29 kg/m (18 to 51). Outcome was reported using the Harris Hip Score (HHS), complications, failures and survival.

RESULTS

The mean follow-up was 3.5 years (1 to 11). The mean HHS improved from 46 (15 to 90) pre-operatively to 75 (14 to 100). A total of 21 hips (22%) had at least one complication with some having more than one; including dislocation (6%), infection (6%), and femoral complications (2%). The implant was subsequently removed in five hips (5%), only one for suspected aseptic loosening.

CONCLUSION

The Triflange patient specific acetabular component provides predictable fixation with complication rates which are similar to those of other techniques. Cite this article: 2018;100-B(1 Supple A):50-4.

摘要

目的

对于需要进行复杂髋臼翻修的患者,如涉及Paprosky 2C、3A和3B型缺损以及骨盆不连续的患者,可用的重建技术很少。我们的目的是描述用于这些患者的定制三翼髋臼组件的研发、手术技术和中期结果。我们包括术前CT扫描、模型构建、手术规划和手术技术的描述。所有植入物均根据需要涂覆有多孔等离子喷涂和羟基磷灰石。

患者与方法

对94例患者的95例复杂髋臼重建进行了多中心回顾性研究。共有61例(64.2%)为女性。患者的平均年龄为66岁(38至85岁)。平均体重指数为29kg/m²(18至51)。使用Harris髋关节评分(HHS)、并发症、失败情况和生存率报告结果。

结果

平均随访时间为3.5年(1至11年)。平均HHS从术前的46分(15至90分)提高到75分(14至100分)。共有21例髋关节(22%)至少出现一种并发症,有些患者出现不止一种并发症;包括脱位(6%)、感染(6%)和股骨并发症(2%)。随后有5例髋关节(5%)取出了植入物,只有1例因怀疑无菌性松动。

结论

定制三翼髋臼组件可提供可预测的固定,并发症发生率与其他技术相似。引用本文:2018;100-B(1增刊A):50-4。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0cc/6424441/51c9690c4e8b/BJJ-2017-0362.R1-galleyfig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0cc/6424441/68622b14c528/BJJ-2017-0362.R1-galleyfig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0cc/6424441/59d4100644cd/BJJ-2017-0362.R1-galleyfig2a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0cc/6424441/0237adb7274f/BJJ-2017-0362.R1-galleyfig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0cc/6424441/aaeb0edff302/BJJ-2017-0362.R1-galleyfig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0cc/6424441/6177f7d4e50f/BJJ-2017-0362.R1-galleyfig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0cc/6424441/51c9690c4e8b/BJJ-2017-0362.R1-galleyfig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0cc/6424441/68622b14c528/BJJ-2017-0362.R1-galleyfig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0cc/6424441/59d4100644cd/BJJ-2017-0362.R1-galleyfig2a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0cc/6424441/0237adb7274f/BJJ-2017-0362.R1-galleyfig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0cc/6424441/aaeb0edff302/BJJ-2017-0362.R1-galleyfig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0cc/6424441/6177f7d4e50f/BJJ-2017-0362.R1-galleyfig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0cc/6424441/51c9690c4e8b/BJJ-2017-0362.R1-galleyfig6.jpg

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