Toni A, Sudanese A, Bueno Lozano A L, Calista F, Fabbri F, Scimeca G B, Masetti G, Giunti A
Clinica Ortopedica, Istituto Ortopedico Rizzoli, Bologna.
Chir Organi Mov. 1994 Oct-Dec;79(4):387-96.
The clinical and radiographic results of 95 acetabular reimplantations performed between 1984 and 1992 are presented. A screwed acetabular prosthesis was used in 56 patients, the acetabulum was cemented in 15, and a press-fit acetabulum stabilized by screws (1 case without screws) was used in 24. Mean clinical follow-up was 35.6 +/- 24 months, ranging from 7 to 94 months. Clinical results were good and excellent (> or = 5 points according to Merle D'Aubigné) in 77% of the cases for pain, in 70% for walking, and in 71% for joint movement. Forty months after surgery 48% of the screwed acetabula and 44% of the cemented ones were osteointegrated. The incidence of loosening for the screwed acetabula was 24%. The preliminary results 24 months after the press-fit acetabula with screws had been inserted showed 100% osteointegration. Radiographic results of the screwed acetabula were satisfactory (92% osteointegration) only in reimplantations performed in patients with minimum acetabular osteolytic injury (Paprosky types I and IIA). The use of homoplastic bone grafts did not improve the radiographic results of the screwed acetabula in the cases with severe osteolysis: 57% of the acetabula screwed on grafts distributed throughout the acetabulum were, in fact, loosened.
本文介绍了1984年至1992年间进行的95例髋臼再植入手术的临床和影像学结果。56例患者使用了带螺钉的髋臼假体，15例进行了髋臼骨水泥固定，24例使用了通过螺钉固定（1例未用螺钉）的压配式髋臼。平均临床随访时间为35.6±24个月，范围从7个月至94个月。临床结果显示，77%的病例疼痛情况良好或优秀（根据Merle D'Aubigné评分≥5分），70%的病例行走情况良好或优秀，71%的病例关节活动情况良好或优秀。术后40个月，48%的带螺钉髋臼和44%的骨水泥固定髋臼实现了骨整合。带螺钉髋臼的松动发生率为24%。在插入带螺钉的压配式髋臼24个月后的初步结果显示骨整合率为100%。仅在髋臼溶骨损伤最小的患者（Paprosky I型和IIA型）进行的再植入手术中，带螺钉髋臼的影像学结果才令人满意（骨整合率为92%）。在严重骨溶解的病例中，使用同种异体骨移植并未改善带螺钉髋臼的影像学结果：事实上，在整个髋臼分布有移植骨的情况下，57%的带螺钉髋臼发生了松动。
