非骨水泥增强型与骨水泥型双动式髋臼杯：病例系列的中期结果和对照组比较
Cementless augmented versus cemented Dual Mobility cups: medium-term outcome of case series with a control group.
机构信息
Department of Orthopedic Surgery, Menoufia University Faculty of Medicine, Shebin El-Kom, 32511, Menoufia, Egypt.
出版信息
BMC Musculoskelet Disord. 2023 Feb 6;24(1):97. doi: 10.1186/s12891-023-06204-4.
BACKGROUND
Post-operative dislocation and reconstruction of acetabular defects are two challenging topics in revision Total Hip Arthroplasty (rTHA). Cemented Dual Mobility (DM) cups on top of Kerboull Cross and bone graft have been successfully employed to overcome these challenges. The cementless augmented DM cups were recently introduced. In this study medium term results of the augmented cementless DM Coptos cups are reported and compared to the established technique of cemented DM cups and Kerboull plate.
MATERIAL AND METHODS
This is a retrospective analysis of data collected on patients who received rTHA using DM cups in the period between June 2015 and September 2020. Two groups of patients were identified. The first group received cementless augmented DM-cups (NOVAE® Coptos TH-SERF) (Coptos TH cup group). The second comparable group who had Kerboull ring (KE ring group) and cemented DM cups (NOVAE® STICK). Demographic data, surgical technique, functional and radiological outcome as well as complications during the follow-up visits are reported.
RESULTS
Forty-two patients with a mean age at the time of revision 48.8 ± 13.6 years. 29 patients received Coptos TH DM-cup, while 13 patients had Bone Graft (BG), KE ring and cemented DM cups for acetabular reconstruction. Acetabular defects were Paprosky types IIB and IIC in 31 patients and IIIA and B in 11 patients. The follow-up was 52.8 ± 21 months (mean ± STD); and the mean Harris Hip Score (HHS) at last visit was 91 ± 5. Good stability of all cups was reported. Full integration of the impaction graft was observed in 94% of the Coptos and 92% of the KE groups. One of the Coptos cups was readjusted and one case of single dislocation was recorded in the KE group. None of the DM cups in both groups was revised or awaiting revision.
CONCLUSION
Coptos TH cups achieve similar results to the cemented DM on KE ring at the medium term but long term outcome remains to be seen.
背景
术后髋关节脱位和髋臼缺损重建是翻修全髋关节置换术（rTHA）的两个挑战。在 Kerboull 十字交叉和植骨的基础上使用骨水泥固定双动（DM）杯已成功克服了这些挑战。最近引入了非骨水泥增强型 DM 杯。本研究报告了增强型非骨水泥 DM Coptos 杯的中期结果，并与骨水泥固定 DM 杯和 Kerboull 板的既定技术进行了比较。
材料和方法
这是对 2015 年 6 月至 2020 年 9 月期间接受 DM 杯翻修的患者数据进行的回顾性分析。确定了两组患者。第一组接受非骨水泥增强型 DM 杯（NOVAE® Coptos TH-SERF）（Coptos TH 杯组）。第二组为具有 Kerboull 环（KE 环组）和骨水泥固定 DM 杯（NOVAE® STICK）的可比组。报告了随访期间的人口统计学数据、手术技术、功能和影像学结果以及并发症。
结果
42 名患者，平均年龄为 48.8±13.6 岁。29 名患者接受了 Coptos TH DM 杯，而 13 名患者接受了髋臼重建的骨移植（BG）、KE 环和骨水泥固定 DM 杯。髋臼缺损在 31 名患者中为 Paprosky Ⅱ B 型和Ⅱ C 型，在 11 名患者中为Ⅲ A 型和 B 型。随访时间为 52.8±21 个月（平均值±标准差）；末次随访时平均 Harris 髋关节评分（HHS）为 91±5。报告所有杯子均具有良好的稳定性。在 Coptos 组和 KE 组中，分别有 94%和 92%的患者观察到嵌压植骨完全融合。Coptos 组中有一个杯子需要调整，KE 组中有一例单发性脱位。两组均未对 DM 杯进行翻修或有待翻修。
结论
在中期，Coptos TH 杯与骨水泥固定的 KE 环 DM 杯取得了相似的结果，但长期结果仍有待观察。
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