Ploynumpon Patcharavit, Sritumma Rutthakorn, Chompoosang Thakrit
Rajavithi Hospital, Faculty of Medicine, Department of Orthopedics, Ratchathewi District, Bangkok, Thailand.
Acta Ortop Bras. 2024 Jun 24;32(2):e273746. doi: 10.1590/1413-785220243202e273746. eCollection 2024.
Severe acetabular bone defects can pose challenges in revision total hip replacement. The use of structural allografts and various sizes of grain allografts has been proposed as an alternative surgical technique for treating Paprosky type 3 acetabular defects. This study aimed to evaluate the long-term outcomes and potential complications associated with this approach.
A retrospective review was performed on 102 hip reconstructions in patients with major acetabular bone loss, including 81 cases of type 3A and 21 cases of type 3B according to Paprosky's classification. Surgical procedures involved the use of structural allografts and various sizes of grain allografts in both reinforcement ring group and cementless cups group.
At a mean follow-up of 82.75 months, 76% of hips had no complications, while The others experienced pain changes in the cup position, post-operative dislocations, and infections. The mean pre-operative Modified Harris Hip Score improved in both groups at the last follow-up.
The use of structural allografts and various sizes of grain allografts for treating type 3 acetabular defects in revision total hip replacement showed promising long-term outcomes and a low rate of complications.
严重的髋臼骨缺损在全髋关节翻修术中可能带来挑战。使用结构性同种异体骨移植和各种尺寸的颗粒状同种异体骨移植已被提议作为治疗Paprosky 3型髋臼缺损的一种替代手术技术。本研究旨在评估这种方法的长期疗效和潜在并发症。
对102例髋臼严重骨量丢失患者的髋关节重建进行回顾性分析,根据Paprosky分类,其中81例为3A 型,21例为3B型。手术方法包括在加强环组和非骨水泥杯组中使用结构性同种异体骨移植和各种尺寸的颗粒状同种异体骨移植。
平均随访82.75个月时,76%的髋关节无并发症,其他患者出现髋臼杯位置疼痛变化、术后脱位和感染。两组患者末次随访时的术前改良Harris髋关节评分均有所改善。
在全髋关节翻修术中使用结构性同种异体骨移植和各种尺寸的颗粒状同种异体骨移植治疗3型髋臼缺损显示出良好的长期疗效和较低的并发症发生率。