Ji Baochao, Li Guoqing, Zhang Xiaogang, Wang Yang, Mu Wenbo, Cao Li
Department of Orthopaedics, the First Affiliated Hospital of Xinjiang Medical University, 137 South LiYuShan Road, 830054, Urumqi, Xinjiang, China.
Arthroplasty. 2021 Jul 6;3(1):26. doi: 10.1186/s42836-021-00081-9.
In revision hip arthroplasty, managing the large protrusio acetabular defects remains a challenge. The report described a novel technique which employs a trabecular metal revision shell as a super-augment to buttress the superior medial structure.
Between January 2015 and December 2018, the multicup reconstruction was performed in 21 patients with severe protrusio acetabular defects. The revision shell, plus two similar porous acetabular components was implanted into the initial shell to create a "multicup" construct. The functional outcomes were evaluated in terms of the Harris Hip Score. Acetabular loosening, restoration of hip center of rotation, and bone ingrowth etc., were radiographically assessed. The survival rate of the implants was also evaluated.
A followup lasting a mean time of 31 months (range, 18-57 months) revealed that the average Harris Hip Score improved from preoperative 37.0 ± 7.1 to postoperative 76.4 ± 9.0. There were no revisions due to acetabular loosening. The horizontal offset increased by an average of 14 mm, and the vertical offset decreased by an average of 18 mm. Eighteen of the 21 patients (86 %) met at least 3 of 5 criteria associated with bone ingrowth. The survivorship free from re-revision for acetabular loosening after 2 years was 100 %.
The multicup reconstruction technique was a simplified re-revision procedure for managing the severe protrusio acetabular defects and could achieve a high survival rate.
Therapeutic study, Level IVa.
在髋关节翻修术中，处理髋臼严重内陷缺损仍是一项挑战。本报告描述了一种新技术，该技术采用小梁金属翻修髋臼杯作为超级加强件来支撑髋臼上内侧结构。
2015年1月至2018年12月期间，对21例髋臼严重内陷缺损患者进行多杯重建。将翻修髋臼杯与另外两个类似的多孔髋臼部件植入初始髋臼杯中，构建“多杯”结构。根据Harris髋关节评分评估功能结果。通过影像学评估髋臼松动、髋关节旋转中心的恢复以及骨长入等情况。同时评估植入物的生存率。
平均随访31个月（范围18 - 57个月）显示，Harris髋关节评分平均从术前的37.0±7.1提高到术后的76.4±9.0。没有因髋臼松动而进行翻修的病例。水平偏移平均增加14 mm，垂直偏移平均减少18 mm。21例患者中有18例（86%）至少满足与骨长入相关的5项标准中的3项。2年后因髋臼松动无需再次翻修的生存率为100%。
多杯重建技术是一种用于处理严重髋臼内陷缺损的简化翻修手术，可实现较高的生存率。
治疗性研究，IVa级。
