Wilson M G, Scott R D
Harvard Medical School, Boston, MA.
J Arthroplasty. 1993 Aug;8(4):405-11. doi: 10.1016/s0883-5403(06)80040-9.
Twenty-two hips with protrusio acetabular deformity in 14 patients received bipolar socket hemiarthroplasty combined with bone-grafting to the medial wall defect. The surgical technique included crushed cancellous grafting and attention to adequate rim contact for the socket. Results were evaluated at a mean of 54 months after surgery (range, 36-76 months). On hip had thigh pain attributable to a loose femoral component. No patient had groin pain at follow-up examination. A satisfactory range of motion was achieved in all but one case, and an average increase of 40 points in the Harris hip score was realized. Radiographically, all acetabuli were returned to a more normal, inferolateral position. Socket migration (measured relative to the teardrop) in the range of 3-7 mm was noted in 5 hips; the remaining 17 hips displayed no or minimal migration of the socket (< 3 mm). The bipolar socket with crushed cancellous graft appears to be an acceptable surgical alternative in protrusio acetabuli, providing a reliable relief of pain, satisfactory functional results, and a restoration of acetabular bone stock in the majority of cases.
14例患者的22个髋关节存在髋臼内陷畸形，接受了双极髋臼杯半关节成形术并对髋臼内壁缺损处进行植骨。手术技术包括松质骨碎骨移植，并注意髋臼杯要有足够的边缘接触。术后平均54个月（范围36 - 76个月）对结果进行评估。1例髋关节因股骨部件松动出现大腿疼痛。随访检查时无患者出现腹股沟疼痛。除1例病例外，所有病例均获得了满意的活动范围，Harris髋关节评分平均提高了40分。影像学检查显示，所有髋臼均恢复到更正常的下外侧位置。5个髋关节出现髋臼杯移位（相对于泪滴测量），移位范围为3 - 7mm；其余17个髋关节未出现或仅有极小的髋臼杯移位（<3mm）。带松质骨碎骨移植的双极髋臼杯似乎是髋臼内陷的一种可接受的手术选择，在大多数病例中能可靠地缓解疼痛，获得满意的功能结果，并恢复髋臼骨量。
