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重建笼在髋臼翻修术中的应用：临床与放射学研究结果及 EBRA 迁移分析。

Outcome and EBRA migration analysis of a reconstruction cage in acetabular revision arthroplasty: a clinical and radiological study.

机构信息

Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.

Department of Experimental Orthopedics, Medical University of Innsbruck, Innrain 36, 6020, Innsbruck, Austria.

出版信息

Arch Orthop Trauma Surg. 2021 Mar;141(3):509-516. doi: 10.1007/s00402-020-03722-x. Epub 2020 Dec 22.

DOI:10.1007/s00402-020-03722-x
PMID:33354743
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7900083/
Abstract

PURPOSE

Restoration cages and bone allografts have been proposed to manage severe acetabular bone defects. We aimed to investigate the migration behaviour of a restoration cup and impacted allograft bone in severe acetabular defects with Einzel-Bild-Röntgen-Analyse (EBRA).

METHODS

Applying a retrospective study design, 64 cases treated between 2009 and 2016 were reviewed. We determined the preoperative Charlson Comorbidity Index (CCI), pre- to postoperative WOMAC score, blood loss and functional outcome. From preoperative x rays, the acetabular deficiencies were classified according to Paprosky. Cup migration analyses were performed with EBRA.

RESULTS

Mean age at surgery was 73 (range: 38-93) years. According to the classification by Paprosky et al., 50% (n = 32) of our patients showed a type III B and 28.1% (n = 18) a type III A defect. Radiological follow-up for migration analysis was 35 (range: 4-95) months. Migration analysis showed a mean cup migration of 0.7 mm (range: 5.7-9.6) medial and 1.8 mm (range: 1.7-12.6) cranial.

CONCLUSION

In conclusion, acetabular restoration cages in combination with bone impaction grafting showed a low revision rate at a mean follow-up of 35 months. Mean cup migration revealed low rates after 2 years and suggested a stable postoperative implant position.

摘要

目的

修复笼和同种异体骨已被提议用于治疗严重的髋臼骨缺损。我们旨在通过 Einzel-Bild-Röntgen-Analyse（EBRA）研究严重髋臼缺损中修复杯和受冲击同种异体骨的迁移行为。

方法

应用回顾性研究设计，回顾了 2009 年至 2016 年间治疗的 64 例病例。我们确定了术前 Charlson 合并症指数（CCI）、术前至术后 WOMAC 评分、出血量和功能结果。从术前 X 射线中，根据 Paprosky 分类髋臼缺陷。使用 EBRA 进行杯迁移分析。

结果

手术时的平均年龄为 73 岁（范围：38-93 岁）。根据 Paprosky 等人的分类，我们患者的 50%（n=32）显示 3B 型，28.1%（n=18）显示 3A 型缺陷。用于迁移分析的放射学随访时间为 35（范围：4-95）个月。迁移分析显示，平均杯迁移为 0.7 毫米（范围：5.7-9.6）内侧和 1.8 毫米（范围：1.7-12.6）头侧。

结论

总之，髋臼修复笼结合骨冲击移植在平均 35 个月的随访中显示出较低的翻修率。平均杯迁移在 2 年后显示出较低的发生率，表明术后植入物位置稳定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7c/7900083/577e892948c2/402_2020_3722_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7c/7900083/20393e456f04/402_2020_3722_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7c/7900083/c1db5e9494fb/402_2020_3722_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7c/7900083/577e892948c2/402_2020_3722_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7c/7900083/20393e456f04/402_2020_3722_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7c/7900083/c1db5e9494fb/402_2020_3722_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7c/7900083/577e892948c2/402_2020_3722_Fig3_HTML.jpg

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本文引用的文献

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ACETABULAR RECONSTRUCTION IN PAPROSKY TYPE III DEFECTS.帕罗斯基III型缺损的髋臼重建
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Acetabular Cup Revision.髋臼杯翻修术
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