California Orthopedics & Spine, Larkspur, CA.
Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.
J Arthroplasty. 2018 Jul;33(7S):S186-S190. doi: 10.1016/j.arth.2018.02.042. Epub 2018 Mar 27.
The purpose of this study was to examine the outcomes of repeat revision after failure of a constrained liner.
We reviewed 1212 consecutive revisions and identified 74 (6%) revisions of a failed constrained liner in 46 patients with a mean age of 65 years. The most common reasons for revision of a constrained liner were recurrent instability (64.9%) and infection (25.7%).
At a mean of 35 months, 42 of the 74 hips (57%) required repeat revision. Kaplan-Meier revision-free survival was 24% at 10 years. Thirty-two of the 74 revisions (43%) had a dislocation event after the index revision. Kaplan-Meier dislocation-free survival was 43% at 10 years. There was a higher failure rate among the 34 patients with abductor deficiency (hazard ratio 1.90, 95% confidence interval, 1.06-3.43; P = .032).
Patients undergoing revision of a failed constrained liner have a high likelihood of recurrent dislocation and repeat revision surgery.
Level IV.
本研究旨在探讨约束型衬垫翻修失败后的治疗效果。
我们回顾了 1212 例连续翻修病例，其中 46 例（6%）患者因约束型衬垫翻修失败而接受了翻修手术，这些患者的平均年龄为 65 岁。约束型衬垫翻修的最常见原因是复发性不稳定（64.9%）和感染（25.7%）。
平均随访 35 个月后，74 髋中有 42 髋（57%）需要再次翻修。10 年时的 Kaplan-Meier 无翻修生存率为 24%。74 次翻修中有 32 次（43%）发生了脱位事件。10 年时的 Kaplan-Meier 无脱位生存率为 43%。在存在臀中肌缺损的 34 例患者中，失败率更高（风险比 1.90，95%置信区间为 1.06-3.43；P=0.032）。
约束型衬垫翻修失败的患者有很高的复发性脱位和再次翻修手术的可能性。
IV 级。
