Aprato Alessandro, Olivero Matteo, Branca Vergano Luigi, Massè Alessandro
Università degli studi di Torino.
Acta Biomed. 2019 Jan 10;90(1-S):24-31. doi: 10.23750/abm.v90i1-S.8081.
To investigate the clinical, radiological and functional outcomes of acetabular revisions with acetabular reinforcement rings and cages.
A comprehensive literature study of international databases was performed. Inclusion criteria were cementless revisions, use of reinforcement rings, radiological and clinical follow-up, availability of full text in English, publication between January 1990 and July 2018. In a second further analysis, we selected only studies describing patients with more severe acetabular defects (AAOS 3, AAOS 4, Paprosky III). Data extracted included mean follow-up period, radiographic follow-up, functional scores, implant failures and survival rate.
We included in our review 1327 acetabular revisions described in 28 articles. The most commonly used reinforcement rings were Burch-Schneider ring, the Muller ring and the Ganz ring. Mean follow-up for all patients together was 8.8 years. Clinical or radiological signs of loosening were reported in 191 patients, 83 patients needed further acetabular revision for aseptic loosening and 41 patients received additional surgeries for septic loosening. The mean value of the Harris Hip Score reported at the last follow-up was 76.3. Nineteen articles fulfilled the criteria for further analysis about high-grade acetabular bone defects. We analyzed 649 revisions with mean follow-up period of 8.2 years. Clinical or radiological loosening was reported in 90 patients, additional acetabular revision was performed in 39 patients and 25 patients needed further surgeries for deep infection.
Acetabular revisions with cages are characterized by good survival rates and functional scores with a mean follow-up period of 8 years.
探讨使用髋臼加强环和髋臼杯进行髋臼翻修术的临床、影像学及功能预后。
对国际数据库进行全面的文献研究。纳入标准为非骨水泥型翻修术、使用加强环、影像学及临床随访、有英文全文、发表时间在1990年1月至2018年7月之间。在进一步分析中，我们仅选择描述髋臼缺损更严重（AAOS 3级、AAOS 4级、Paprosky III型）患者的研究。提取的数据包括平均随访时间、影像学随访、功能评分、植入物失败情况及生存率。
我们的综述纳入了28篇文章中描述的1327例髋臼翻修术。最常用的加强环是Burch-Schneider环、Muller环和Ganz环。所有患者的平均随访时间为8.8年。191例患者报告有临床或影像学松动迹象，83例患者因无菌性松动需要进一步进行髋臼翻修，41例患者因感染性松动接受了额外手术。最后一次随访时报告的Harris髋关节评分平均值为76.3。19篇文章符合关于高级别髋臼骨缺损进一步分析的标准。我们分析了649例翻修术，平均随访时间为8.2年。90例患者报告有临床或影像学松动，39例患者进行了额外的髋臼翻修，25例患者因深部感染需要进一步手术。
使用髋臼杯进行髋臼翻修术的特点是平均随访8年时生存率和功能评分良好。
