Baba Tomonori, Homma Yasuhiro, Jinnai Yuta, Tanabe Hiroki, Banno Sammy, Watari Taiji, Kaneko Kazuo
Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan.
SICOT J. 2020;6:2. doi: 10.1051/sicotj/2019040. Epub 2020 Jan 14.
The purpose of this study was to investigate revision with a Kerboull-type plate through the posterior approach (PA) and direct anterior approach (DAA) and compare the clinical outcome.
Fifty-four patients (56 hip joints) underwent revision surgery in which acetabular reconstruction was performed concomitantly using the Kerboull-type plate and allogeneic bone. Revision surgery through DAA was performed in 21 hip joints and these were compared with 34 hip joints treated through PA. There was no significant difference in the patient demographics between the DAA and PA.
There was no significant difference between the operative times in the DAA and PA groups (203.2 ± 43.5 and 211.7 ± 41.8 min). There was a significant difference between the intraoperative blood loss in the DAA and PA groups (503.9 ± 223.7 mL and 703.8 ± 329.6 mL, respectively, p < 0.05). There was no significant difference between the modified Harris Hip Score in the DAA and the PA groups. The loosening of the acetabular component was observed in four cases (11.8%) in the PA group. In the DAA and PA groups, the 5-year survival rates were 100 and 85.7%, respectively. Recurrent dislocation of the hip was observed in six cases (one case in the DAA group (4.8%) and five cases in the PA group (14.7%)).
It was verified that the difference in the surgical approach of acetabular reconstruction concomitantly using the Kerboull-type plate and allogeneic bone graft influenced the postoperative outcome.
本研究的目的是探讨采用Kerboull型钢板经后路（PA）和直接前路（DAA）进行翻修手术，并比较临床结果。
54例患者（56个髋关节）接受了翻修手术，术中使用Kerboull型钢板和同种异体骨进行髋臼重建。21个髋关节采用DAA进行翻修手术，并与34个采用PA治疗的髋关节进行比较。DAA组和PA组患者的人口统计学特征无显著差异。
DAA组和PA组的手术时间无显著差异（分别为203.2±43.5分钟和211.7±41.8分钟）。DAA组和PA组的术中失血量有显著差异（分别为503.9±223.7毫升和703.8±329.6毫升，p<0.05）。DAA组和PA组的改良Harris髋关节评分无显著差异。PA组有4例（11.8%）观察到髋臼组件松动。在DAA组和PA组中，5年生存率分别为100%和85.7%。6例观察到髋关节复发性脱位（DAA组1例（4.8%），PA组5例（14.7%））。
证实了同时使用Kerboull型钢板和同种异体骨移植进行髋臼重建的手术入路差异会影响术后结果。
