在髋关节翻修手术中应用钽增强物修复髋臼骨缺损

A. Cursaru, B. Șerban, A. Lupu, D. Anghelescu, G. Iacobescu, M. Popa, C. Cirstoiu
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引用次数: 1

摘要

抽象的目的。本研究的目的是对髋关节翻修手术中髋臼骨缺损患者的临床和功能进行随访。材料和方法。该研究是回顾性的,为期6年(2014年1月至2019年1月),包括所有髋关节置换术患者,髋臼骨严重缺损,需要钽块替代。11例患者(男8例,女3例)纳入研究。平均年龄为71岁(64 - 78岁)。平均随访时间23个月(11 ~ 36个月)。术前采用帕普罗斯基放射学分级法对骨缺损进行评估。9例为2B型帕普罗斯基骨缺损,2例为3A型。术前和术后分别测定Harris评分,以评价功能结果。结果:6例继发于发育不良的肩关节置换,2例继发于无菌性坏死的肩关节置换,3例原发性肩关节置换。从初次关节置换术到需要翻修手术的平均时间为13年(7至16年)。术后放射学评估显示髋关节旋转中心从术后平均垂直位置3.1 cm (1.2 - 4.6 cm)改善到术后平均垂直位置1.1 cm (0.5 - 2.3 cm)。术后Harris评分平均36分(39 ~ 96分)。随访期间无早期松动、感染或假体脱位。结论。钽增强物用于髋臼骨缺损翻修手术是一个很好的选择,可以矫正髋关节旋转中心,从而大大提高功能评分。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Using Tantalum Augments for Major Acetabular Bone Defects in Revision Hip Surgery
Abstract Aim. The purpose of the study was to follow up the clinical and functional results of the patients with major acetabular bone defects in revision hip surgery. Materials and methods. The study was retrospective, over a period of six years (from January 2014 to January 2019), and included all the patients with hip replacement, with major acetabular bone defects, who needed Tantalum blocks substitution. 11 patients were included in the study (8 men and 3 women). The average age was 71 years (between 64 and 78 years old). The average follow up period was 23 months (between 11 and 36 months). Paprosky radiological classification was used for the preoperatory evaluation of the bone defects. In 9 cases, the bone defect was of type 2B Paprosky and in 2 cases, of type 3A. Harris score was determined preoperatory and postoperatory for the appreciation of functional results. Results. 6 patients were underwent replacement for coxarthrosis secondary to dysplasia, 2 patients for coxarthrosis secondary to aseptic necrosis and 3 patients for primary coxarthrosis. The average time elapsed from the moment of primary arthroplasty to the need of revision surgery was on average of 13 years (between 7 and 16 years). The postoperatory radiological evaluation showed an improvement of the hip rotation center from an average postoperative vertical position of 3.1 cm (between 1.2 and 4.6 cm) at an average postoperatory position of 1.1 cm (between 0.5 and 2.3). The average result of Harris score postoperatively was 36 (between 39 and 96). During the follow up period, no early loosening, infection or prosthesis dislocation was registered. Conclusions. The Tantalum Augments used in major acetabular bone defects in revision surgery represent a good option, correcting the hip rotation center, thus considerably improving the functional score.
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