Sugano Nobuhiko, Ando Wataru, Tamura Kazunori, Maeda Yuki, Uemura Keisuke, Takashima Kazuma, Hamada Hidetoshi
Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Suita, Japan.
Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Japan.
Bone Jt Open. 2025 May 1;6(5 Supple A):57-64. doi: 10.1302/2633-1462.65.BJO-2024-0221.R1.
This study aimed to evaluate the efficacy of porous titanium acetabular augments in primary total hip arthroplasty (THA) for reconstruction of superolateral acetabular bone defects in patients with Crowe II or higher classes of developmental dysplasia of the hip (DDH) or rapidly destructive coxopathy (RDC).
We conducted a retrospective evaluation of 27 patients (30 hips) who underwent primary THA using cementless cups and porous titanium acetabular augments. The follow-up periods ranged from two to 11 years, with a mean of 5.0 years. The cohort included 22 females (24 hips) and five males (six hips), with a mean age of 67 years (45 to 83) at the time of surgery.
At the final follow-up, there was no radiological evidence of loosening or radiolucency around the cups and augments, indicating successful biological fixation in all cases. Clinically, there was a significant improvement in the Western Ontario and McMaster Universities Osteoarthritis Index score, which improved from a mean of 39.1 (SD 14.7) preoperatively to 5.1 (SD 6.4) postoperatively.
The use of cementless cups and porous acetabular titanium augments in primary THA for patients with DDH and RDC can lead to considerable clinical improvements and reliable biological fixation, suggesting their potential as a viable solution for managing challenging acetabular defects in these conditions.
本研究旨在评估多孔钛髋臼增强物在初次全髋关节置换术(THA)中对Crowe II级或更高等级发育性髋关节发育不良(DDH)或快速破坏性髋关节病(RDC)患者重建髋臼上外侧骨缺损的疗效。
我们对27例(30髋)接受使用非骨水泥髋臼杯和多孔钛髋臼增强物的初次THA手术的患者进行了回顾性评估。随访时间为2至11年,平均5.0年。该队列包括22名女性(24髋)和5名男性(6髋),手术时的平均年龄为67岁(45至83岁)。
在最后一次随访时,没有影像学证据表明髋臼杯和增强物周围出现松动或透亮区,表明所有病例均成功实现生物固定。临床上,西安大略和麦克马斯特大学骨关节炎指数评分有显著改善,从术前的平均39.1(标准差14.7)提高到术后的5.1(标准差6.4)。
在DDH和RDC患者的初次THA中使用非骨水泥髋臼杯和多孔钛髋臼增强物可带来显著的临床改善和可靠的生物固定,表明它们有可能成为处理这些情况下具有挑战性的髋臼缺损的可行解决方案。