Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, 208512Kagoshima University, Kagoshima, Japan.
Department of Medical Joint Materials, Graduate School of Medical and Dental Sciences, 208512Kagoshima University, Kagoshima, Japan.
J Orthop Surg (Hong Kong). 2022 May-Aug;30(2):10225536221119719. doi: 10.1177/10225536221119719.
One of the major problems in revision total hip arthroplasty (THA) is severe acetabular bone loss. The aim of our study was to evaluate the clinical outcomes of revision THA using a Kerboull-type reinforcement device (KT plate) and allogeneic structural bone graft.
This retrospective study evaluated 48 hips that underwent revision THA using a KT plate and allogeneic structural bone graft between 2008 and 2016, with a median follow-up of 6.2 years (range 3-12.6 years). Functional outcome was assessed using the Japanese Orthopaedic Association (JOA) hip score. Postoperative and follow-up radiographs were compared to assess migration and breakage of the implant.
The mean JOA hip score improved from 45.6 (±16.3) points before surgery to 72.1 (±11.9) points at the most recent follow-up examination ( < 0.001). Two hips (4.2%) underwent re-revision THA because of cup loosening due to breakage of the KT plate. A total of 13 hips (27.1%) were classified as radiological failures. Binomial logistic regression analysis showed that a Kawanabe classification of stage 4, which indicates massive bone defects in the weight-bearing area, was a risk factor for radiological failure (odds ratio: 4.57; 95% confidence interval: 1.01-26.35).
A KT plate with an allogeneic structural bone graft is a useful method of acetabular reconstruction in revision THA that restores bone stock and improves hip function. Our findings indicated that a Kawanabe classification of stage 4 was a risk factor for radiological failure of the implant.
翻修全髋关节置换术（THA）的主要问题之一是严重的髋臼骨丢失。我们的研究目的是评估使用 Kerboull 型加强装置（KT 板）和同种异体结构性骨移植物进行翻修 THA 的临床结果。
这项回顾性研究评估了 2008 年至 2016 年间使用 KT 板和同种异体结构性骨移植物进行翻修 THA 的 48 例髋关节，中位随访时间为 6.2 年（3-12.6 年）。使用日本矫形协会（JOA）髋关节评分评估功能结果。比较术后和随访的 X 线片，以评估植入物的迁移和断裂。
JOA 髋关节评分从术前的 45.6（±16.3）分提高到最近随访时的 72.1（±11.9）分（<0.001）。由于 KT 板断裂导致杯松动，有 2 例（4.2%）需要再次翻修 THA。共有 13 例（27.1%）被归类为影像学失败。二项逻辑回归分析显示，Kawanabe 分期 4 级（表示负重区有大量骨缺损）是影像学失败的危险因素（比值比：4.57；95%置信区间：1.01-26.35）。
KT 板联合同种异体结构性骨移植物是翻修 THA 中髋臼重建的一种有效方法，可恢复骨量并改善髋关节功能。我们的研究结果表明，Kawanabe 分期 4 级是植入物影像学失败的危险因素。
