Tamaki Tatsuya, Ninomiya Taishi, Jonishi Kurato, Miura Yoko, Oinuma Kazuhiro, Shiratsuchi Hideaki
Joint Reconstruction Center, Funabashi Orthopedic Hospital, Chiba, Japan.
J Orthop Surg (Hong Kong). 2018 May-Aug;26(2):2309499018782553. doi: 10.1177/2309499018782553.
The direct anterior approach has gained popularity in total hip arthroplasty (THA) over the past decade. However, there are few reports that describe the use of this approach for cases of complex revision. The purpose of this study was to report the surgical procedure and early clinical results of acetabular revision in the presence of bone defects using a Kerboull-type reinforcement device through the direct anterior approach.
Eleven patients who had undergone acetabular reconstruction using a Kerboull-type reinforcement device for aseptic or septic loosening bone defects were enrolled. All procedures were performed using the direct anterior approach on a standard operating table. The mean age was 71.8 years, the mean period from initial surgery to revision THA was 14.5 years, and the mean follow-up period was 19.8 months.
The Kerboull-type acetabular reinforcement device with cemented cup combined with allogenic femoral head bone grafts was used in all hips. The mean operative time and intraoperative blood loss were 148 min and 743 g, respectively. None of the patients required allogeneic blood transfusion. One patient required revision surgery 11 months postoperatively because of device displacement. No other major or minor orthopedic complications were observed.
The direct anterior approach allows for less invasive acetabular reconstruction using a Kerboull-type reinforcement device.
在过去十年中，直接前路入路在全髋关节置换术（THA）中越来越受欢迎。然而，很少有报道描述这种入路在复杂翻修病例中的应用。本研究的目的是报告通过直接前路入路使用Kerboull型加强装置对存在骨缺损的髋臼进行翻修的手术过程和早期临床结果。
纳入11例使用Kerboull型加强装置进行髋臼重建以治疗无菌性或感染性松动骨缺损的患者。所有手术均在标准手术台上采用直接前路入路进行。平均年龄为71.8岁，初次手术至翻修THA的平均时间为14.5年，平均随访时间为19.8个月。
所有髋关节均使用带骨水泥杯的Kerboull型髋臼加强装置并联合异体股骨头植骨。平均手术时间和术中失血量分别为148分钟和743克。所有患者均无需异体输血。1例患者术后11个月因装置移位需要翻修手术。未观察到其他严重或轻微的骨科并发症。
直接前路入路允许使用Kerboull型加强装置进行侵入性较小的髋臼重建。
