Xia Ming, Li Dongbo, Zhu Chunquan, Sun Lihui, Li Dongsong
Department of Orthopedics, The First Hospital of Jilin University, Changchun, Jilin, China.
Front Surg. 2025 Aug 22;12:1655804. doi: 10.3389/fsurg.2025.1655804. eCollection 2025.
Acetabular reconstruction is often challenging in revision hip arthroplasty, especially in the face of moderate to severe acetabular bone deficiency. In some severe bone defects, double-metal tantalum cups can improve the contact area between bone and implants, increase the surface area for bone ingrowth, and better restore the anatomical position of the acetabulum. Furthermore, with a good press-fit, the auxiliary screw has a minimal effect on acetabular cup stability.
We report a case of a 63-year-old male patient who was diagnosed with loosening prosthesis after total hip arthroplasty and whose preoperative radiograph suggested a large bone defect in the acetabulum. Due to the large amount of purulent fluid found in the joint cavity during the first revision surgery, a decision was made to stage-1spacer placement followed by a second-stage revision. In the second-stage revision, we utilized a double-cup technique to fill the large acetabular bone defect.
In the revision total hip arthroplasty, if the acetabular bone defect is severe, a double-metal tantalum cup structure can be used to reconstruct the acetabular structure, restore the center of rotation of the hip joint. Under good press-fit conditions, the metal tantalum cup can obtain initial stability of sufficient strength even without screw fixation, and achieve secondary stability through bone growth.
在髋关节翻修术中,髋臼重建往往具有挑战性,尤其是在面对中度至重度髋臼骨缺损时。在一些严重的骨缺损中,双金属钽杯可以改善骨与植入物之间的接触面积,增加骨长入的表面积,并更好地恢复髋臼的解剖位置。此外,在良好的压配情况下,辅助螺钉对髋臼杯稳定性的影响最小。
我们报告一例63岁男性患者,该患者在全髋关节置换术后被诊断为假体松动,术前X线片显示髋臼存在大的骨缺损。由于在首次翻修手术中关节腔内发现大量脓性液体,决定先行一期置入间隔器,然后进行二期翻修。在二期翻修中,我们采用双杯技术来填充大的髋臼骨缺损。
在髋关节翻修术中,如果髋臼骨缺损严重,可采用双金属钽杯结构重建髋臼结构,恢复髋关节旋转中心。在良好的压配条件下,金属钽杯即使不使用螺钉固定也能获得足够强度的初始稳定性,并通过骨生长实现二期稳定。