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髋关节陈旧性下脱位致翻修全髋关节置换失败后的再次翻修：1例有趣的病例报告

Re-revision Following Failed Revision Total Hip Arthroplasty in a Case of Neglected Inferior Dislocation of the Hip: An Interesting Case Report.

作者信息

Agrawal Alok Chandra, Garg Ankit Kumar, Chauhan Shivam, Singh Jagprit, Sakale Harshal, Saparey Lohitesh

机构信息

Department of Orthopaedic Surgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.

出版信息

J Orthop Case Rep. 2025 May;15(5):10-15. doi: 10.13107/jocr.2025.v15.i05.5536.

DOI:10.13107/jocr.2025.v15.i05.5536
PMID:40351616
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12064230/
Abstract

INTRODUCTION

Revision arthroplasty is challenging, especially in severe acetabular bone loss cases. Metal augments have emerged as a viable option for managing such complex defects.

CASE REPORT

We report a case of a 59-year-old male who underwent re-revision arthroplasty using a metal augment for severe acetabular bone loss, restoring limb length and anatomical hip center following a failed revision total hip arthroplasty in a case of neglected inferior hip dislocation. The patient presented with significant pain, instability, and limited mobility. Postoperative outcomes showed considerable improvement, with a Harris Hip Score increasing from 37 to 82 at the 12-month follow-up.

CONCLUSION

In conclusion, this case report demonstrates the effectiveness of metal augments in revision arthroplasty for managing significant bone loss. Careful patient selection and expert surgical techniques can provide a reliable solution for ensuring stable fixation and improving clinical outcomes in complex revision surgeries.

摘要

引言

翻修关节成形术具有挑战性，尤其是在髋臼严重骨缺损的病例中。金属增强物已成为处理此类复杂缺损的一种可行选择。

病例报告

我们报告一例59岁男性患者，其在因忽视性髋关节下脱位导致初次翻修全髋关节置换术失败后，使用金属增强物进行再次翻修关节成形术，以修复严重髋臼骨缺损，恢复肢体长度和髋关节解剖中心。患者表现为严重疼痛、不稳定和活动受限。术后结果显示有显著改善，在12个月随访时，Harris髋关节评分从37分提高到82分。

结论

总之，本病例报告证明了金属增强物在翻修关节成形术中处理严重骨缺损的有效性。仔细的患者选择和专业的手术技术可为确保复杂翻修手术中的稳定固定和改善临床结果提供可靠的解决方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f970/12064230/db0d12c14e22/JOCR-15-10-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f970/12064230/f3f4c4c0c1a3/JOCR-15-10-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f970/12064230/1b795673c235/JOCR-15-10-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f970/12064230/db0d12c14e22/JOCR-15-10-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f970/12064230/f3f4c4c0c1a3/JOCR-15-10-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f970/12064230/1b795673c235/JOCR-15-10-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f970/12064230/db0d12c14e22/JOCR-15-10-g004.jpg

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本文引用的文献

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J Arthroplasty. 2023 Feb;38(2):389-396.e1. doi: 10.1016/j.arth.2022.08.010. Epub 2022 Aug 12.
2
Cup-Cage Solution for Massive Acetabular Defects: A Systematic Review and Meta-Analysis.用于巨大髋臼缺损的杯笼解决方案：系统评价与荟萃分析
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Acetabular reconstruction in revision total hip arthroplasty.翻修全髋关节置换术中的髋臼重建
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Survivorship and Clinical Outcomes of Custom Triflange Acetabular Components in Revision Total Hip Arthroplasty: A Systematic Review.定制三叶髋臼假体在全髋关节翻修术中的生存状况和临床疗效的系统评价。
J Arthroplasty. 2019 Oct;34(10):2511-2518. doi: 10.1016/j.arth.2019.05.032. Epub 2019 May 29.
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Reconstruction of failed acetabular component in the presence of severe acetabular bone loss: a systematic review.严重髋臼骨缺损情况下失败髋臼假体的翻修：一项系统评价
Musculoskelet Surg. 2019 Apr;103(1):1-13. doi: 10.1007/s12306-018-0539-7. Epub 2018 Apr 13.
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Joint perception and patient perceived satisfaction after total hip and knee arthroplasty in the American population.美国人群全髋关节和膝关节置换术后的关节感知与患者感知满意度
J Orthop. 2018 Mar 30;15(2):495-499. doi: 10.1016/j.jor.2018.03.018. eCollection 2018 Jun.
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The Evolution of the Cup-Cage Technique for Major Acetabular Defects: Full and Half Cup-Cage Reconstruction.杯-笼技术在髋臼大缺损中的演变：全杯-笼和半杯-笼重建。
J Bone Joint Surg Am. 2017 Jul 5;99(13):1104-1110. doi: 10.2106/JBJS.16.00821.
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Ten-Year Trends and Independent Risk Factors for Unplanned Readmission Following Elective Total Joint Arthroplasty at a Large Urban Academic Hospital.大型城市学术医院择期全关节置换术后非计划再入院的十年趋势及独立危险因素
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Current Construct Options for Revision of Large Acetabular Defects: A Systematic Review.当前用于翻修大型髋臼缺损的结构选择：一项系统评价。
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