Xue Zhaoxi, Ding Zhipeng, Mu Wenbo, Guo Wentao, Xu Boyong, Cao Li
Department of Orthopaedics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Key Laboratory of High Incidence Disease Research in Xinjiang (Xinjiang Medical University), Urumqi, Xinjiang, China; Xinjiang Clinical Research Center for Orthopedics, Urumqi, Xinjiang, China.
J Arthroplasty. 2025 Jul 24. doi: 10.1016/j.arth.2025.07.047.
In revision total hip arthroplasty (THA), surgeons may encounter a well-fixed acetabular component that requires liner revision, particularly when a compatible liner is unavailable or the original locking mechanism is damaged. Cementing a new liner into the well-fixed cup may be an option. There are currently limited reports on this technique, consisting of small cohort studies or those with only early outcomes. This study aimed to evaluate the clinical outcomes at a mean follow-up of 7.7 years of liners cemented into well-fixed acetabular components.
We retrospectively reviewed 62 revision THAs in which liners were cemented into well-fixed acetabular components. The average follow-up period was 7.7 years. The mean age at the time of revision THA was 54 years, with 67.7% of the patients being women. The most common indications for surgery included liner wear in 33 hips, dislocation in 14 hips, and early-stage periprosthetic joint infection in 13 hips.
The survivorship free from rerevision for any reason was 88.7% (95% confidence interval = 81.0 to 97.0). The most common complication was dislocation, occurring in seven patients, with three of these requiring rerevision. This was followed by periprosthetic joint infection in three patients, and there was one patient in whom the liner dissociated from the acetabular component. Patients who underwent previous revisions were more prone to rerevision (P < 0.001), and those who underwent revision due to dislocation were at a higher risk of postoperative dislocation (P = 0.038).
Cementing a liner into a well-fixed acetabular component during revision THA provides favorable clinical outcomes at mean 7.7-year follow-up. Patients undergoing revision due to dislocation face a higher risk of postoperative dislocation. In addition, patients who had a history of previous revisions tend to have a higher risk of rerevision.
在翻修全髋关节置换术（THA）中，外科医生可能会遇到一个固定良好的髋臼组件，但需要更换内衬，尤其是当没有兼容的内衬或原始锁定机制受损时。将新内衬用骨水泥固定到固定良好的髋臼杯中可能是一种选择。目前关于该技术的报道有限，包括小型队列研究或仅有早期结果的研究。本研究旨在评估平均随访7.7年时，将内衬用骨水泥固定到固定良好的髋臼组件中的临床结果。
我们回顾性分析了62例翻修THA病例，这些病例将内衬用骨水泥固定到固定良好的髋臼组件中。平均随访期为7.7年。翻修THA时的平均年龄为54岁，67.7%的患者为女性。最常见的手术指征包括33髋的内衬磨损、14髋的脱位和13髋的早期假体周围关节感染。
因任何原因无需再次翻修的生存率为88.7%（95%置信区间=81.0至97.0）。最常见的并发症是脱位，7例患者发生脱位，其中3例需要再次翻修。其次是3例患者发生假体周围关节感染，1例患者的内衬与髋臼组件分离。既往接受过翻修手术的患者更容易再次翻修（P<0.001），因脱位接受翻修的患者术后脱位风险更高（P=0.038）。
在翻修THA期间将内衬用骨水泥固定到固定良好的髋臼组件中，在平均7.7年的随访中提供了良好的临床结果。因脱位接受翻修的患者术后脱位风险更高。此外，有既往翻修史的患者再次翻修的风险往往更高。
