Orthopedic Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Artificial Joints Engineering and Technology Research Center of Jiangxi Province, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Orthop Surg. 2024 Nov;16(11):2853-2861. doi: 10.1111/os.14248. Epub 2024 Sep 23.
This study aimed to investigate the application of the cup-on-cup technique in revision total hip arthroplasty (THA) and report clinical and radiographic outcomes from a series of case follow-ups. Retrospective analysis of 10 patients who underwent acetabular prosthesis revision with cup-on-cup technique. According to the Paprosky classification of acetabular bone defects, there were 2 cases of type II C, 3 cases of type III A, and 5 cases of type III B. The average follow-up was 54.8 ± 5.1 months, and the Harris score of the hip joint increased from 37.0 ± 9.9 preoperatively to 80.5 ± 3.1 postoperatively at the final follow-up (p < 0.001). Comparing the surgical side's hip center of rotation (COR) to the contralateral side, the preoperative average upward displacement was 33.8 ± 15.0 mm, while the postoperative average upward displacement was 0.2 ± 3.3 mm (p < 0.001). Similarly, the preoperative average inward displacement was 9.1 ± 5.1 mm, while the postoperative average outward displacement was 1.8 ± 1.6 mm (p < 0.001). There was no significant difference (p = 0.71) between the average density values of the contralateral and surgical sides at the final follow-up, which were 127.4 ± 13.7 and 125.0 ± 14.8, respectively. During the follow-up period, all patients achieved satisfactory radiographic outcomes, and no prosthetic loosening was observed. The cup-on-cup technique can reconstruct acetabular bone defects and restore hip COR in revision THA, with favorable clinical and radiographic outcomes.
本研究旨在探讨杯对杯技术在翻修全髋关节置换术（THA）中的应用，并报告一系列病例随访的临床和影像学结果。回顾性分析了 10 例采用杯对杯技术行髋臼假体翻修的患者。根据髋臼骨缺损的 Paprosky 分类，其中 2 例为 II C 型，3 例为 III A 型，5 例为 III B 型。平均随访时间为 54.8±5.1 个月，髋关节 Harris 评分由术前的 37.0±9.9 分提高至末次随访时的 80.5±3.1 分（p<0.001）。比较手术侧髋关节中心旋转（COR）与对侧，术前平均向上移位 33.8±15.0mm，术后平均向上移位 0.2±3.3mm（p<0.001）。同样，术前平均向内移位 9.1±5.1mm，术后平均向外移位 1.8±1.6mm（p<0.001）。末次随访时，对侧与手术侧的平均骨密度值无显著差异（p=0.71），分别为 127.4±13.7 和 125.0±14.8。随访期间，所有患者均获得满意的影像学结果，未见假体松动。杯对杯技术可重建髋臼骨缺损，恢复翻修 THA 髋关节 COR，具有良好的临床和影像学结果。
