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病例报告:用于严重髋臼骨缺损的无辅助螺钉双小梁金属杯。

Case Report: Double trabecular metal cup without auxiliary screws for severe acetabular bone defects.

作者信息

Xia Ming, Li Dongbo, Zhu Chunquan, Sun Lihui, Li Dongsong

机构信息

Department of Orthopedics, The First Hospital of Jilin University, Changchun, Jilin, China.

出版信息

Front Surg. 2025 Aug 22;12:1655804. doi: 10.3389/fsurg.2025.1655804. eCollection 2025.

Abstract

BACKGROUND

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.

CASE PRESENTATION

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.

CONCLUSIONS

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.

摘要

背景

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。

病例报告

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0dd/12412307/4e194b78b5f9/fsurg-12-1655804-g001.jpg

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