Cipolla Alessandra, Vella-Baldacchino Martinique, Le Baron Marie, Argenson Jean-Noel, Flecher Xavier
University of Turin, CTO Hospital (C.T.O. Centro Traumatologico Ortopedico), Torino, Italy; Aix-Marseille University, AP-HM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopedics and Traumatology, Marseille, France.
Aix-Marseille University, AP-HM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopedics and Traumatology, Marseille, France; MSk Lab - Imperial College London, Department of Surgery & Cancer, Sir Michael Uren Hub, London, UK.
J Arthroplasty. 2025 May;40(5):1284-1292. doi: 10.1016/j.arth.2024.10.110. Epub 2024 Oct 29.
Managing acetabular defects and restoring the hip center of rotation (COR) in revision hip arthroplasty is considered a complex and challenging surgery. Among many existing options, porous tantalum components have shown favorable short-term (less than ten years) follow-up results. The present study aimed to describe clinical and radiographic outcomes in longer-term follow-up.
Between 2006 and 2013, 98 patients who underwent this surgical technique in our institute were clinically and radiographically reviewed. Rerevisions for aseptic loosening of the acetabular component were examined to consider the survivorship of the implant as the primary endpoint. The clinical outcome was measured using the Harris Hip Score. Radiological signs of osseointegration, radiolucency lines, acetabular stability, and position of the hip COR were evaluated at the immediate postoperative and last follow-up radiographs.
The cup survivorship was 96% at a mean follow-up of 14 years (range, 10 to 17). Global survivorship was 83.6% if any reason for rerevisions was considered an endpoint. The most frequent complications were dislocation (13.7%) and infections (12%). Overall, 13 patients died, and 17 patients were lost to follow-up. There were 73 patients available for clinical and radiographic evaluation. The mean Harris Hip Score was 81 (range, 39 to 100). More than 80% of hips showed radiological evidence of osseointegration, and no change was found in COR position at last follow-up radiographs.
The use of porous tantalum uncemented components to manage revision hip arthroplasty can be considered a favorable solution for managing acetabular defects and restoring the hip COR with satisfactory clinical and radiological results in a long-term follow-up.
在髋关节翻修术中，处理髋臼缺损并恢复髋关节旋转中心（COR）被认为是一项复杂且具有挑战性的手术。在众多现有选择中，多孔钽组件已显示出良好的短期（少于十年）随访结果。本研究旨在描述长期随访中的临床和影像学结果。
2006年至2013年期间，对在我院接受该手术技术的98例患者进行了临床和影像学复查。检查髋臼组件无菌性松动的再次翻修情况，将植入物的生存率作为主要终点。使用Harris髋关节评分来衡量临床结果。在术后即刻和最后一次随访的X线片上评估骨整合、透亮线、髋臼稳定性和髋关节COR位置的影像学征象。
平均随访14年（范围10至17年）时，髋臼杯生存率为96%。如果将任何再次翻修的原因视为终点，则总体生存率为83.6%。最常见的并发症是脱位（13.7%）和感染（12%）。总体而言，13例患者死亡，17例患者失访。有73例患者可进行临床和影像学评估。Harris髋关节评分的平均值为81（范围39至100）。超过80%的髋关节显示出骨整合的影像学证据，在最后一次随访的X线片上COR位置未发现变化。
使用多孔钽非骨水泥组件进行髋关节翻修术可被视为处理髋臼缺损和恢复髋关节COR的一种良好解决方案，在长期随访中具有令人满意的临床和影像学结果。
