作为关节型髋关节垫片用于治疗慢性人工关节感染的骨水泥约束衬垫

IF 1.5 Q3 ORTHOPEDICS
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引用次数: 0

摘要

背景两阶段置换关节成形术仍是治疗慢性髋关节假体周围感染的金标准。然而,关于最佳垫片类型仍存在争议,尤其是在脱位风险较高的患者中。本研究报告了采用单一约束衬垫设计的铰接式髋关节垫片的疗效。方法筛选在一家机构接受髋关节假体周围感染治疗的所有患者。如果患者接受的是使用单一制造商设计的约束衬垫的铰接式垫片,则将其纳入研究范围。记录了约束衬垫的适应症、人口统计学变量和手术变量。在进行第二阶段手术之前,或在最后随访时(如果未进行第二阶段手术),对患者进行脱位和组件松动评估。结果25名患者共使用了26个约束衬垫。约束衬垫的适应症包括脱位史(14例)、股骨近端大量骨质流失(14例)、大转子缺损(12例)和外展肌缺失(7例)。许多患者有不止一个适应症。共有 9 个髋关节(34.6%)在平均 7.4 个月后接受了第二期手术,而 17 个髋关节从未接受过第二期手术,平均随访时间为 27.6 个月。一名患者由于骨盆不连续性和大量髋臼骨质流失,在第二阶段之前经历了约束衬垫的失败。缜密的骨水泥技术、适当的组件位置和植入物选择是取得成功结果的关键。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cemented Constrained Liners Used as an Articulating Hip Spacer for the Treatment of Chronic Prosthetic Joint Infection

Background

Two-stage exchange arthroplasty remains the gold standard for treating chronic hip periprosthetic joint infections. However, controversy remains regarding the optimal spacer type, particularly among patients with increased dislocation risk. This study reports on the outcomes of articulating hip spacers utilizing a single constrained-liner design.

Methods

All patients who underwent treatment for hip periprosthetic joint infection at a single institution were screened. Patients were included if they received an articulating spacer utilizing a constrained liner of a single manufacturer design. Indications for constrained liner, demographic variables, and surgical variables were recorded. Patients were assessed for dislocation and component loosening prior to the second stage or at the final follow-up if the second stage was not undertaken. Comparative analysis was performed.

Results

Overall, 26 constrained liners were utilized in 25 patients. Indications for constrained liner included history of dislocation (n = 14), massive proximal femoral bone loss (n = 14), greater trochanteric deficiency (n = 12), and absent abductors (n = 7). Many patients had more than one indication. In total, 9 hips (34.6%) underwent a second stage at an average of 7.4 months, while 17 hips never underwent a second stage with an average follow-up of 27.6 months. One patient experienced failure of their constrained liner prior to the second stage due to pelvic discontinuity and massive acetabular bone loss.

Conclusions

Utilization of a constrained liner as an articulating spacer is a viable option for patients at high risk of instability. Meticulous cement technique, appropriate component position, and implant selection are crucial in achieving successful outcomes.

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来源期刊
Arthroplasty Today
Arthroplasty Today Medicine-Surgery
CiteScore
2.90
自引率
0.00%
发文量
258
审稿时长
40 weeks
期刊介绍: Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.
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