Department of Orthopaedics and Traumatology - San Polo Hospital - Monfalcone (GO).
Acta Biomed. 2022 Mar 10;92(S3):e2021549. doi: 10.23750/abm.v92iS3.12398.
Loss of bone stock is the main problem in revision hip arthroplasty. Porous tantalum cups and augment constructs are possible solutions. The aim of this study was to describe results at an average follow-up of 10 years using these cups.
25 patients underwent to revision hip arthroplasty with porous tantalum cups. Acetabular bone defects were classified according to Paprosky's in type II and III. All patients were reviewed clinically and radiographically at an average follow-up of 10 years (range 8.5 to 13 years). Changes in inclination angle of the cup and position of the hip centre of rotation (COR - measured and calculated using Pierchon's method), and possible periacetabular radiolucency lines were assessed.
A statistically significant improvement in Harris Hip Score and hip range of motion was observed. The hip COR had been lowered by 19.33 mm after revision and no changes in COR position had been measured at follow-up. Kaplan-Meier survivorship was 100% at an average follow-up of 10 years, considering acetabular revision for any reasons as primary endpoint. 88% of patients was satisfied. Complications were 3 dislocations, 4 asymptomatic heterotopic ossifications and 1 partial reabsorption of greater trochanter.
Porous tantalum cups and augments can be considered a valid solution in acetabular revisions for addressing massive bone defects and restoring the hip COR.
骨量丢失是翻修髋关节置换术的主要问题。多孔钽杯和增强结构是可能的解决方案。本研究的目的是描述使用这些杯子平均随访 10 年后的结果。
25 例患者接受多孔钽杯翻修髋关节置换术。髋臼骨缺损根据 Paprosky 分类为 II 型和 III 型。所有患者均在平均 10 年(8.5 至 13 年)的随访期内进行临床和影像学评估。评估了髋臼杯倾斜角度和髋关节旋转中心(COR-使用 Pierchon 方法测量和计算)的位置变化,以及可能出现的髋臼周围放射性透亮线。
观察到 Harris 髋关节评分和髋关节活动范围有统计学意义的改善。翻修后髋关节 COR 降低了 19.33 毫米,随访时 COR 位置没有变化。以任何原因进行髋臼翻修为主要终点,平均随访 10 年的 Kaplan-Meier 生存率为 100%。88%的患者满意。并发症包括 3 例脱位、4 例无症状异位骨化和 1 例大转子部分吸收。
多孔钽杯和增强物可被认为是解决大量骨缺损和恢复髋关节 COR 的髋臼翻修的有效解决方案。