Miettinen Hannu Ja, Miettinen Simo Sa, Kettunen Jukka S, Jalkanen Jussi, Kröger Heikki
Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Pohjois-Savo, Finland.
Faculty of Health Sciences, University of Eastern Finland, Kuopio, Pohjois-Savo, Finland.
Hip Int. 2021 Nov;31(6):782-788. doi: 10.1177/1120700020913294. Epub 2020 Apr 20.
Reconstruction of acetabulum in case of bone defects can be challenging. The aim of this retrospective study was to investigate the 10-year survival of trabecular tantalum metal (TM) acetabulum component in revision hip arthroplasty operations and to evaluate complications.
A total of 100 consecutive acetabulum revision hip arthroplasties (100 patients) were operated on between May 2004 and October 2006 at Kuopio University Hospital. The mean follow-up time was 9.4 years and the median was 11.5 years (SD 4.118; range 0.1-13.4 years). Kaplan-Meier survival analysis was performed to study the survival of patients to re-revision surgery. Intra- and postoperative complications and reasons for re-revision were evaluated.
The Kaplan-Meier analysis showed a cumulative proportion of revision hip survivorship of 66% at 13.4 years (SE 0.403, 95% CI, 10.886-12.466) based on the need for further re-revision surgery for any major reason. The Kaplan-Meier survival analysis of time to re-revision surgery due acetabular component loosening showed a cumulative proportion of survivorship of 98.9% at 13.4 years (SE 0.136; 95% CI, 12.998-13.529). There were a total of 41/100 complications and the most common complication was dislocation (24/100). Re-revision for any major reason was performed on 18/100 of the revision arthroplasties. The mean time to re-revision was 4.9 years (SD 5.247; range 0.1-13.2 years).
The trabecular TM acetabular component gives excellent outcomes regarding stability and fixation to the acetabulum in acetabulum revision hip arthroplasty at a minimum of ten years of follow-up. However, acetabular component malposition and the small head size (28 mm) are risk factors for dislocation.
髋臼骨缺损的重建具有挑战性。本回顾性研究的目的是调查小梁钽金属（TM）髋臼组件在髋关节翻修手术中的10年生存率，并评估并发症。
2004年5月至2006年10月期间，在库奥皮奥大学医院连续对100例髋臼翻修髋关节置换术（100例患者）进行了手术。平均随访时间为9.4年，中位数为11.5年（标准差4.118；范围0.1 - 13.4年）。采用Kaplan-Meier生存分析来研究患者至再次翻修手术的生存率。评估了术中及术后并发症以及再次翻修的原因。
Kaplan-Meier分析显示，基于任何主要原因需要进一步再次翻修手术，在13.4年时髋关节翻修生存率的累积比例为66%（标准误0.403，95%置信区间，10.886 - 12.466）。因髋臼组件松动导致再次翻修手术时间的Kaplan-Meier生存分析显示，在13.4年时生存率的累积比例为98.9%（标准误0.136；95%置信区间，12.998 - 13.529）。100例患者中共有41例出现并发症，最常见的并发症是脱位（24/100）。100例翻修关节成形术中，18例因任何主要原因进行了再次翻修。再次翻修的平均时间为4.9年（标准差5.247；范围0.1 - 13.2年）。
小梁TM髋臼组件在髋臼翻修髋关节置换术中，至少经过十年随访，在髋臼的稳定性和固定方面给出了优异的结果。然而，髋臼组件位置不良和小头尺寸（28毫米）是脱位的危险因素。
