Pu Xingxiao, Wang Qiuru, Li Qianhao, Cai Lijun, Han Guangtao, Kang Pengde
Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024 Dec 15;38(12):1530-1536. doi: 10.7507/1002-1892.202408064.
To summarize research progress on application of Cup-cage reconstruction in revision of chronic pelvic discontinuity (CPD) in patients undergoing total hip arthroplasty (THA).
Relevant literature at home and abroad in recent years was reviewed to summarize the principles of the Cup-cage reconstruction, preoperative patient assessment, intraoperative skills, clinical and radiological effectiveness, limitations, and postoperative complications.
For the treatment of CPD, the Cup-cage reconstruction achieved long-term acetabular cup bone ingrowth, CPD healing, and biologic fixation of the prosthesis by restoring pelvic continuity. Preoperative evaluation of the surgical site and general condition is necessary. The main intraoperative objectives are to reconstruct pelvic continuity, restore the center of rotation of the hip, and avoid neurovascular injury. Current studies have demonstrated significant clinical and radiological effectiveness as well as acceptable prosthesis survival rates after operation. Nevertheless, there is a lack of evidence regarding the staging of CPD, the optimal surgical approach and internal fixation, and the factors influencing postoperative prosthesis survival remain undefined.
Cup-cage reconstruction can be an effective treatment for CPD after THA, but there is still a need to explore CPD staging, Cup-cage approach and internal fixation, and influencing factors on prosthesis survival.
总结髋臼杯-骨笼重建在全髋关节置换术(THA)患者慢性骨盆不连续(CPD)翻修中的应用研究进展。
回顾近年来国内外相关文献,总结髋臼杯-骨笼重建的原则、术前患者评估、术中技巧、临床及影像学疗效、局限性和术后并发症。
对于CPD的治疗,髋臼杯-骨笼重建通过恢复骨盆连续性实现了髋臼杯的长期骨长入、CPD愈合和假体的生物固定。术前对手术部位和全身状况进行评估很有必要。术中主要目标是重建骨盆连续性、恢复髋关节旋转中心并避免神经血管损伤。目前的研究表明,术后具有显著的临床和影像学疗效以及可接受的假体生存率。然而,关于CPD的分期、最佳手术入路和内固定缺乏证据,影响术后假体生存的因素仍不明确。
髋臼杯-骨笼重建可以是THA后CPD的有效治疗方法,但仍需要探索CPD分期、髋臼杯-骨笼入路和内固定以及假体生存的影响因素。