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髋关节翻修术中的骨水泥型双动髋臼杯:不同的使用可能性

THE CEMENTED DOUBLE MOBILITY CUP IN HIP REVISION: DIFFERENT POSSIBILITIES OF USE.

作者信息

de Cano Jaime José Morales, Trias Estela

机构信息

Hospital Universitario de Vic, Vic, Vic, Spain.

出版信息

Acta Ortop Bras. 2023 Apr 17;31(spe1):e256913. doi: 10.1590/1413-785220233101e256913. eCollection 2023.

Abstract

INTRODUCTION

The aim of our work is to review those patients who underwent prosthetic hip revision surgery in our hospital considered to be patients at high risk of dislocation or recurrent dislocation, and who underwent a double mobility cemented cup (CMD). Analyzing the different ways to place these cups and the clinical results and reluxations.

MATERIAL AND METHODS

The 69 cases comprised 34 men and 35 women with a mean age of 77,39 years. The mean follow-up was 4.7536 years. The type of intervention performed varied according to the cause of the intervention, the acetabular bone stock and the state of the primary cup. In the cases in which there was a good fixation of the primary metalback, we opted to carry out a cementation of the cemented DMC into the existing well-fixed metal acetabular shell, this occurred in 23 cases. In the cases where there was loosening of the primary cup but there was a good bone stock, a CMD was cemented into the bone (21 cases). In the cases where there was a Paprosky type III we cemented a DMC to a Bursch-Schneider reinforcement ring together with the placement of a cancellous bone graft (25 cases).

RESULTS

The clinical evaluation at the end of the follow-up, according to the MD Scale, showed the mean value was 16.454 (SD 0.79472), with a survival at the end of the follow-up of 100% of the placed DMC.

CONCLUSION

The use of cemented DMC is a good solution in the replacement of THA, especially in cases of reluxation or risk of dislocation due to personal or technical predisposing factors. The use of these DMC cemented can be directly to the bone, into the existing well-fixed metal Shell, or cemented to a reinforcing ring, depending on the acetabular defect. .

摘要

引言

我们的工作目的是回顾那些在我院接受人工髋关节翻修手术的患者,这些患者被认为是脱位或反复脱位的高危患者,并且接受了双动型骨水泥杯(CMD)植入。分析植入这些髋臼杯的不同方法以及临床结果和再脱位情况。

材料与方法

69例患者中,男性34例,女性35例,平均年龄77.39岁。平均随访时间为4.7536年。根据干预原因、髋臼骨量和初次髋臼杯的状况,所进行的干预类型有所不同。在初次金属杯固定良好的病例中,我们选择将骨水泥型双动杯(DMC)植入现有的固定良好的金属髋臼壳中,这种情况发生在23例患者中。在初次髋臼杯松动但骨量良好的病例中,将CMD植入骨中(21例)。在Paprosky III型病例中,我们将DMC与松质骨移植一起固定在Bursch-Schneider加强环上(25例)。

结果

随访结束时根据MD量表进行的临床评估显示,平均值为16.454(标准差0.79472),随访结束时所植入的DMC的生存率为100%。

结论

骨水泥型DMC的使用是全髋关节置换术的一种良好解决方案,特别是在因个人或技术易感因素导致再脱位或脱位风险的病例中。根据髋臼缺损情况,这些骨水泥型DMC可以直接植入骨中、植入现有的固定良好的金属壳中或固定在加强环上。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f63/10112351/2ad5848b62eb/1809-4406-aob-31-spe1-e256913-gf01.jpg

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