Wu Isabella T, Politzer Cary S, Chiarappa Frank, Ball Scott T
Department of Orthopaedic Surgery, University of California, San Diego, San Diego, CA, USA.
Arthroplast Today. 2025 Jan 2;31:101595. doi: 10.1016/j.artd.2024.101595. eCollection 2025 Feb.
Management of periacetabular osteolysis is a challenging dilemma in revision total hip arthroplasty. When the acetabular shell is well-fixed, the surgeon may prefer to retain the cup to minimize further bone loss. However, filling the surrounding defect can be difficult if the area of involvement is massive. In this case, holes were created in the existing acetabular cup for supplemental pelvic screws, which were placed using computed tomography navigation, and then the areas of osteolysis were filled with cement. The patient recovered uneventfully, and he was satisfied with the outcome at 4 years postoperatively. Thus, pelvic screw placement with cement augmentation could be a viable option for a stable cup with surrounding osteolysis. Patient selection should be considered carefully as the long-term outcomes of this procedure are unknown.
髋臼周围骨溶解的处理是翻修全髋关节置换术中一个具有挑战性的难题。当髋臼杯固定良好时，外科医生可能倾向于保留髋臼杯以尽量减少进一步的骨质流失。然而，如果受累面积较大，填充周围的缺损可能会很困难。在这种情况下，在现有的髋臼杯中钻孔以置入补充性骨盆螺钉，使用计算机断层扫描导航放置这些螺钉，然后用骨水泥填充骨溶解区域。患者恢复顺利，术后4年对结果满意。因此，对于伴有周围骨溶解的稳定髋臼杯，置入骨盆螺钉并辅以骨水泥强化可能是一种可行的选择。由于该手术的长期效果尚不清楚，应仔细考虑患者的选择。
