Xue Z X, Maimaitiaimaiti Yilixiati, Guo W T, Xu B Y, Cao L
Department of Orthopaedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China.
Zhonghua Wai Ke Za Zhi. 2024 Sep 1;62(9):847-855. doi: 10.3760/cma.j.cn112139-20240605-00278.
To investigates the clinical efficacy of the trabecular metal acetabular revision system (TMARS) in one-stage reconstruction of acetabular deficiencies associated with periprosthetic joint infection (PJI). This is a retrospective case series study,including the data of 59 patients with PJI underwent acetabular defect reconstruction by TMARS during one-stage revisions in the Department of Orthopaedics, the First Affiliated Hospital of Xinjiang Medical University from January 2013 to December 2021. There were 32 males and 27 females, aged (59.5±14.6) years (range: 26 to 84 years). Among them, 29 cases used tantalum cups, 13 cases used tantalum cups and tantalum reinforcing blocks, 9 cases used cup-cage, and 8 cases used multi-cup reconstruction techniques. The surgery procedure, Harris Hip score (HHS), recovery of the hip rotation center, implant survival rate, postoperative reinfection rate, and complications were recorded. Data were compared using the Wilcoxon rank-sum test. All of the 59 patients underwent the operations successfully. Operation time was (188.9±48.4) minutes (range: 110 to 340 minutes), and intraoperative bleeding volume was ((IQR)) 1 000(400)ml (range: 600 to 1 800 ml). After a postoperative follow-up of 5.1 (2.6) years (range: 2.0 to 10.5 years), the prosthesis survival rate was 94.9% (56/59). Recurrence of infection occurred in 3 cases (5.1%), aseptic loosening in 1case(1.7%), and hip dislocation in 4 cases (6.8%). At the last follow-up, HHS improved significantly(84 (12) 44 (9), =-6.671, <0.01), and the center of rotation of the hips were recovered in all cases. In one-stage revision surgeries aimed at reconstructing acetabular defects, utilizing the TMARS can provide stable initial fixation, restore a more natural center of rotation, significantly enhance early postoperative hip joint function, and reduce the likelihood of infection recurrence. This approach stands as a reliable choice for addressing acetabular defects during revision surgeries for infected hip joints.
探讨小梁金属髋臼翻修系统(TMARS)在一期重建与人工关节周围感染(PJI)相关的髋臼缺损中的临床疗效。这是一项回顾性病例系列研究,纳入了2013年1月至2021年12月在新疆医科大学第一附属医院骨科接受TMARS一期翻修髋臼缺损重建的59例PJI患者的数据。其中男性32例,女性27例,年龄(59.5±14.6)岁(范围:26至84岁)。其中,29例使用钽杯,13例使用钽杯和钽增强块,9例使用杯笼,8例使用多杯重建技术。记录手术过程、Harris髋关节评分(HHS)、髋关节旋转中心恢复情况、植入物生存率、术后再感染率及并发症。数据采用Wilcoxon秩和检验进行比较。59例患者均成功完成手术。手术时间为(188.9±48.4)分钟(范围:110至340分钟),术中出血量为(四分位间距)1000(400)ml(范围:600至1800 ml)。术后随访5.1(2.6)年(范围:2.0至10.5年),假体生存率为94.9%(56/59)。3例(5.1%)发生感染复发,1例(1.7%)发生无菌性松动,4例(6.8%)发生髋关节脱位。末次随访时,HHS显著改善(84(12)比44(9),z=-6.671,P<0.01),所有病例髋关节旋转中心均恢复。在旨在重建髋臼缺损的一期翻修手术中,使用TMARS可提供稳定的初始固定,恢复更自然的旋转中心,显著提高术后早期髋关节功能,并降低感染复发的可能性。该方法是处理感染性髋关节翻修手术中髋臼缺损的可靠选择。