Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, China.
Department of Orthopedics, The First Affiliated Hospital of Bengbu Medical College, Laboratory of Tissue and Transplant in Anhui Province, Bengbu Medical College, Bengbu City, Anhui Province, China.
J Orthop Surg Res. 2020 Apr 16;15(1):152. doi: 10.1186/s13018-020-01670-1.
To restore rotation center exactly in revision hip arthroplasty is technically challenging, especially in Paprosky type III. The technical difficulty is attributable to the complicated acetabular bone defect. In this study, we discussed the method of restoring rotation center in revision hip arthroplasty and reported the clinical and radiological outcome of mid-term and long-term follow-up.
This study retrospectively reviewed 45 patients (48 hips) who underwent revision hip arthroplasty, in which 35 cases (35 hips) were available for complete follow-up data. During the operation, the acetabular bone defect was reconstructed by impaction morselized bone graft, and the hip rotation center was restored by using remnant Harris fossa and acetabular notches as the marks. The clinical outcome was assessed using the Harris hip score. Pelvis plain x-ray was used to assess implant migration, stability of implants, and incorporation of the bone graft to host bone.
The average follow-up duration was 97.60 months (range 72-168 months). The average Harris hip score improved from 29.54 ± 10.87 preoperatively to 83.77 ± 5.78 at the last follow-up. The vertical distance of hip rotation center measured on pelvis x-ray was restored to normal, with the mean distance (15.24 ± 1.31) mm (range 12.4~17.3 mm). The mean loss of vertical distance of hip rotation center was (2.21 ± 0.72) mm (range 1.1 ~ 5.3 mm) at the last follow-up.
Satisfactory clinical and radiological outcome can be obtained through restoring hip rotation center by using remnant Harris fossa and acetabular notches as the anatomical marks in revision hip arthroplasty.
在翻修髋关节置换术中，准确恢复旋转中心具有一定的技术挑战性，尤其是在 Paprosky Ⅲ型中。技术难点归因于复杂的髋臼骨缺损。在本研究中，我们讨论了在翻修髋关节置换术中恢复旋转中心的方法，并报告了中期和长期随访的临床和影像学结果。
本研究回顾性分析了 45 例（48 髋）接受翻修髋关节置换术的患者，其中 35 例（35 髋）有完整的随访资料。术中采用打压植骨颗粒重建髋臼骨缺损，以残余 Harris 窝和髋臼切迹作为标志恢复髋关节旋转中心。采用 Harris 髋关节评分评估临床疗效。骨盆平片评估假体迁移、假体稳定性和植骨与宿主骨的融合情况。
平均随访时间为 97.60 个月（72168 个月）。术前 Harris 髋关节评分为 29.54±10.87 分，末次随访时为 83.77±5.78 分。骨盆 X 线片上髋关节旋转中心的垂直距离恢复正常，平均距离为 15.24±1.31mm（范围 12.417.3mm）。末次随访时髋关节旋转中心垂直距离的平均丢失量为（2.21±0.72）mm（范围 1.1~5.3mm）。
在翻修髋关节置换术中，通过使用残余的 Harris 窝和髋臼切迹作为解剖标志来恢复髋关节旋转中心，可获得满意的临床和影像学结果。
