Nabors E D, Liebelt R, Mattingly D A, Bierbaum B E
Department of Orthopaedic Surgery, New England Baptist Hospital, Boston, MA 02120, USA.
J Arthroplasty. 1996 Feb;11(2):146-52. doi: 10.1016/s0883-5403(05)80008-7.
A retrospective review examined all patients who underwent removal and reinsertion of a cemented femoral component during isolated acetabular revision by one surgeon since 1981. All components were reinserted into the original, intact cement mantle. Forty-two hips with 2- to 10-year follow-up periods were reviewed. Average follow-up period since revision was 67 months. Average followup period since index procedure was 191 months. Average Harris hip score increased from 61 before surgery to 90 at follow-up examination. Two femurs are definitely loose by Harris criteria, but both are asymptomatic. One solidly fixed femoral component was revised because of joint instability. Two hips have postrevision cement fractures. One patient has mild thigh pain. In vitro testing of eight cadaver hips showed no increase in rotational micromotion following removal and reinsertion. It is concluded that this technique aids in isolated acetabular revision surgery by avoiding the complications of trochanteric osteotomy and femoral revision, improving acetabular exposure, and decreasing operative time with minimal risk of disrupting femoral component fixation.
一项回顾性研究调查了自1981年以来由一位外科医生在单纯髋臼翻修术中进行骨水泥型股骨假体取出并重新植入的所有患者。所有假体均重新植入到原来完整的骨水泥壳中。对42例随访2至10年的髋关节进行了评估。翻修术后的平均随访时间为67个月。初次手术以来的平均随访时间为191个月。Harris髋关节评分平均从术前的61分提高到随访时的90分。根据Harris标准，有两根股骨肯定松动，但均无症状。一个牢固固定的股骨假体因关节不稳而进行了翻修。两例髋关节出现翻修术后骨水泥骨折。一名患者有轻度大腿疼痛。对八个尸体髋关节进行的体外测试显示，取出并重新植入后旋转微动没有增加。得出的结论是，该技术通过避免转子截骨术和股骨翻修的并发症、改善髋臼暴露以及减少手术时间，同时将破坏股骨假体固定的风险降至最低，有助于单纯髋臼翻修手术。
