采用双活动杯进行感染全髋关节置换术的两阶段置换具有较低的不稳定性。

IF 1.8 Q2 ORTHOPEDICS
SICOT-J Pub Date : 2025-01-01 Epub Date: 2025-03-20 DOI:10.1051/sicotj/2025013
Nicolas Zadel, Céline Cazorla, Anne Carricajo, Thomas Neri, Frédéric Farizon, Bertrand Boyer
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引用次数: 0

摘要

导读:髋关节假体感染(PJI)的两阶段治疗面临着高脱位率。双活动杯(DM)已被证明可以有效降低脱位的风险,但关于髋关节PJI的两阶段治疗的数据很少。本回顾性队列研究的目的是分析脱位率,脱位复发率,并确定脱位的危险因素。我们的假设是,在两期置换术中使用DM杯具有较低的不稳定性。方法:回顾性整理2011年至2020年在本中心进行的70例DM杯再植两期病变的资料。平均年龄69岁[18-93],平均随访3.4年[1.5-9.6]。收集假体失稳的脱位率和危险因素。进行单因素和多因素分析以确定有利于假体不稳定的危险因素。结果:末次随访脱位率为8.6%(6/70),无感染复发患者脱位率为4.3%(3/70)。感染得到控制后,脱位复发率为0%。间隔位的发生、免疫抑制和抗聚集药物的存在、McPherson评分的局部分级和感染治疗失败与脱位的发生有关。在多变量分析中未发现危险因素。讨论:与文献报道的发生率相比,在这种情况下使用DM杯似乎是为了降低复发性脱位的风险。预防间隔器脱位和感染复发似乎是避免未来假髋关节不稳定风险的关键。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Two-stage exchange of infected total hip arthroplasty with a dual-mobility cup is associated with a low instability rate.

Introduction: The two-stage management of hip Prosthetic Joint Infection (PJI) is faced with a high rate of dislocation. Dual mobility (DM) cups have proved effective in reducing the risk of dislocation, but few data are available on the two-stage management of hip PJI. The objectives of this retrospective cohort study were to analyze the rate of dislocation, and the rate of recurrent dislocation and to identify risk factors for dislocation. Our hypothesis was that the use of a DM cup during a two-stage replacement had a low instability rate.

Methods: Data from 70 two-stage changes with DM cup reimplantation performed in our centre between 2011 and 2020 were retrospectively collated. The mean age was 69 years [18-93], with a mean follow-up of 3.4 years [1.5-9.6]. Dislocation rates and risk factors for prosthetic instability were collected. Univariate and multivariate analyses were performed to identify risk factors favouring prosthetic instability.

Results: The rate of dislocation at the last follow-up was 8.6% (6/70), including 4.3% (3/70) in patients with no infection recurrence. The rate of recurrent dislocation was 0% when infection was controlled. The occurrence of spacer dislocation, the presence of immunosuppressive and antiaggregant medication, the local grade of the McPherson score and infection treatment failure were associated with the occurrence of a dislocation. No risk factors were identified in the multivariate analysis.

Discussion: Compared with the rates reported in the literature, the use of a DM cup seems indicated in this context in order to lower the risk of recurrent dislocation. Preventing spacer dislocation and infection recurrence seems to be essential to avoid the risk of instability of the future prosthetic hip.

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来源期刊
SICOT-J
SICOT-J ORTHOPEDICS-
CiteScore
3.20
自引率
12.50%
发文量
44
审稿时长
14 weeks
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