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髋臼移位至腹膜下空间患者的髋关节翻修术:病例报告。

Revision Hip Arthroplasty in Patient with Acetabulum Migration into Subperitoneal Space-A Case Report.

机构信息

Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, Woycickiego 1/3, 01-938 Warsaw, Poland.

Department of Orthopedic Surgery and Traumatology, Central Research Hospital of Ministry of Interior, Wołoska 137, 02-507 Warszawa, Poland.

出版信息

Medicina (Kaunas). 2020 Dec 31;57(1):30. doi: 10.3390/medicina57010030.

Abstract

Revision hip arthroplasty procedures have been extensively discussed in the literature. At the same time, discussions of the management of acetabular component protrusion into the pelvic cavity, and, more specifically, the subperitoneal space, necessitating an additional abdominal approach for the revision arthroplasty, have only been published as case reports and descriptions of transperitoneal approaches have been even rarer. This paper presents the case of a 63-year-old female patient in whom a peritoneal approach was necessary to access a migrated acetabular component. The outcome of the treatment, which represented a complex orthopedic and general surgical problem, was good. We believe that the complexity of revision hip arthroplasty in patients with protrusion of the acetabular component together with the head and proximal part of the stem of the implant into subperitoneal space calls for a careful re-analysis of the category of Type III bony acetabulum defects according to Paprosky, where the recognition of two subtypes would facilitate analysis of such cases.

摘要

髋关节翻修手术在文献中已有广泛讨论。同时,对于髋臼部件突出到盆腔,更具体地说,突出到腹膜下腔,需要额外的腹部入路进行翻修手术的处理,也仅作为病例报告发表,而经腹腔入路的描述则更为罕见。本文介绍了一位 63 岁女性患者的病例,该患者需要经腹膜入路才能触及移位的髋臼部件。该治疗的结果良好,代表了一个复杂的矫形和普通外科问题。我们认为,对于髋臼部件突出、植入物头部和近端部分进入腹膜下腔的患者,髋关节翻修手术的复杂性要求根据 Paprosky 对 III 型骨髋臼缺损进行仔细的重新分析,其中识别两种亚型将有助于分析此类病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d7e/7824657/a641c602764a/medicina-57-00030-g001.jpg

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