多孔钽微孔金属垫块全髋关节置换术治疗 Crowe Ⅳ 型髋关节发育不良：中期随访研究。
Total hip arthroplasty with porous tantalum trabecular metal pads in patients with Crowe IV developmental dysplasia of the hip: a midterm followup study.
机构信息
Department of Orthopaedics Surgery, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu, Sichuan, 610041, People's Republic of China.
出版信息
BMC Musculoskelet Disord. 2024 Jul 3;25(1):510. doi: 10.1186/s12891-024-07598-5.
PURPOSE
Crowe IV developmental dysplasia of the hip (DDH) is a catastrophic hip disease. Moreover, obtaining ideal clinical efficacy in conventional total hip arthroplasty (THA) is often difficult. In this study, we aimed to assess the mid-term clinical results of THA with porous tantalum trabecular metal (TM) pads for acetabular reconstruction in the treatment of Crowe IV DDH.
METHODS
A cohort of 28 patients (32 hips) diagnosed with Crowe type IV DDH who underwent acetabular reconstruction during THA using TM pads with scheduled follow-up between 2011 and 2018, were included in this study. Eight cases were men and 24 were women, with a mean age of 48.4 years (range, 36-72 years) and a mean follow-up was 74.3 months (range, 42-132 months). All patients underwent acetabular reconstruction using TM pads and total hip replacement with subtrochanteric osteotomy.
RESULTS
At the final follow-up, 28 hips (87.5%) demonstrated mild or no postoperative limping. The Harris Hip Score improved from 58.4 ± 10.6 preoperatively to 85.6 ± 8.9. The mean pain, stiffness, and function scores on the Western Ontario and McMaster University Osteoarthritis index were 86.5 ± 10.2, 87.3 ± 12.4 and 85.4 ± 11.6 respectively. The mean score of patient satisfaction was 90.4 ± 7.6. Additionally, the SF-12 physical summary score was 41.8 ± 5.6 and the SF-12 mental summary score was 51.6 ± 5.4. TM construct survivorship due to all-cause failure was 90.6% at 5 years with 3 hips at risk, 87.5% at 10 years with 4 hips at risk. The survivorship due to failure from aseptic loosening was 96.9% at 5 years with 1hips at risk and 93.75% at 10 years with 2 hips at risk.
CONCLUSION
This study demonstrated satisfactory mid-term clinical and radiological results with the application of TM pads for acetabular reconstruction combined with THA in patients with Crowe IV DDH.
TRIAL REGISTRATION NUMBER
ChiCTR1800014526, Date: 18/01/2018.
目的
Crowe IV 型发育性髋关节发育不良（DDH）是一种灾难性的髋关节疾病。此外，在常规全髋关节置换术（THA）中获得理想的临床疗效往往较为困难。本研究旨在评估使用多孔钽小梁金属（TM）垫块进行髋臼重建治疗 Crowe IV DDH 的 THA 的中期临床结果。
方法
回顾性分析 2011 年至 2018 年间，28 例（32 髋）诊断为 Crowe Ⅳ型 DDH 的患者，均接受 TM 垫块髋臼重建的 THA，平均随访 74.3 个月（42-132 个月）。男 8 例，女 24 例，平均年龄 48.4 岁（36-72 岁）。所有患者均采用 TM 垫块和转子下截骨的全髋关节置换进行髋臼重建。
结果
末次随访时，28 髋（87.5%）术后轻度或无跛行。Harris 髋关节评分从术前的 58.4±10.6 分提高到 85.6±8.9 分。Western Ontario 和 McMaster 大学骨关节炎指数的疼痛、僵硬和功能评分分别为 86.5±10.2、87.3±12.4 和 85.4±11.6。患者满意度平均评分为 90.4±7.6。此外，SF-12 生理总评分为 41.8±5.6，SF-12 心理总评分为 51.6±5.4。TM 结构因各种原因导致的总生存率为 90.6%（5 年，3 髋风险），87.5%（10 年，4 髋风险）。因无菌性松动而导致失败的生存率为 96.9%（5 年，1 髋风险）和 93.75%（10 年，2 髋风险）。
结论
本研究表明，在 Crowe IV DDH 患者中，应用 TM 垫块进行髋臼重建结合 THA 可获得满意的中期临床和影像学结果。
试验注册号
ChiCTR1800014526，登记日期：2018 年 1 月 18 日。
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