带翼加强髋臼杯在翻修全髋置换术的应用  

Application of antiprotrusio cage in revision total hip arthroplasty

作　　者：骆雷锋 刘照树[1] 张潇[1] 张振[2] LUO Lei-feng;LIU Zhao-shu;ZHANG Xiao;ZHANG Zhen(Department of Joint Surgery,Zhoukou Central Hospital,Zhoukou 466000,China;Joint Surgery Department,Henan Provincial Pelple’s Hospital,Zhengzhou450003,China)

机构地区：[1]河南省周口市中心医院关节外科,周口市466000 [2]河南省人民医院关节外科,450003

出　　处：《中国矫形外科杂志》2020年第5期410-414,共5页Orthopedic Journal of China

摘　　要：[目的]评价带翼加强髋臼杯在臼杯假体松动合并髋臼骨缺损髋关节翻修术的运用价值。[方法] 2012年3月~2014年3月,对80例初次人工全髋关节置换术(THA)后臼杯假体松动合并髋臼骨缺损患者采用带翼加强髋臼杯髋关节翻修治疗。记录围手术期资料,采用Harris评分和VAS评分评价临床效果,行影像检查,测量髋关节旋转中心至泪滴外缘的水平距离和旋转中心至双泪滴下缘连线的垂直距离。[结果]所有患者均顺利完成手术,手术用时(118.32±21.44) min,出血量(322.49±32.24) ml,住院时间(12.67±2.91) d。术后4例发生下肢深静脉血栓(DVT),1例住院期间发生肺部感染,无切口感染等并发症。术后随访4~7年,平均随访时间(6.36±0.54)年。随术后时间推移,76例髌股部疼痛逐渐减轻,4例髌股部遗留中度疼痛;73例功能逐渐恢复,7例运动及劳动能力未获明显提升。末次随访Harris评分较术前显著升高,差异有统计学意义(P<0.05)。术后VAS评分较术前显著降低(P<0.05),末次随访时,VAS评分进一步降低,差异有统计学意义(P<0.05)。影像检查显示,与术前比较,术后髋关节旋转中心到泪滴外侧距离显著增加,而髋关节旋转中心到泪滴间线距离显著降低,差异具有统计学意义(P<0.05)。末次随访时,80髋假体位置良好,未见假体及带翼加强髋臼杯松动、移位。臼杯附近存在确切的新生骨小梁重塑征象,股骨大转子延长截骨区均完全愈合。[结论]臼杯假体松动合并髋臼骨缺损范围较大者,采用带翼加强髋臼杯髋关节翻修治疗后髋关节功能恢复及疼痛改善效果优良,远期疗效确切。[Objective] To evaluate the application value of antiprotrusio cage in revision total hip arthroplasty for acetabular component loosening accompanied with acetabular bone defect. [Methods] From March 2012 to March 2014, a total of 80 patients underwent revision total hip arthroplasty with antiprotrusio cage for acetabular component loosening accompanied with acetabular bone defect secondary to primary total hip arthroplasty. The perioperative documentations were recorded, while Harris score and visual analogue scale(VAS) for pain were used for evaluation of the clinical consequences, and images were taken to measure the horizontal distance from the rotate center to the lateral margin of teardrop, and the vertical distance from the rotate center to the connection line of both distal teardrops. [Results] All the patients had operation performed smoothly with operation time of(118.32±21.44) min, intraoperative blood loss of(322.49±32.24) ml and hospital stay of(12.67±2.91) days. Regardless of deep venous thrombosis found in 4 patients and pulmonary infection in 1 patient, no incision infection was noted in anyone of them. The patients were followed up for 4~7 years with a mean of(6.36±0.54) years. All the 80 patients got pain relief and functional improvement as time went postoperatively, without dislocation and sudden pain worsening in anyone of them. The Harris score significantly increased at the latest follow up in contrast to that before operation(P<0.05). In addition, the VAS score significantly decreased immediately postoperatively compared with that before operation(P<0.05), which further decreased significantly at the latest follow up(P<0.05). With regard to radiographic assessments, the horizontal distance from the rotate center to the lateral margin of teardrop significantly increased, whereas the vertical distance from the rotate center to the connection line of both distal ends of teardrops significantly decreased after operation and at the latest follow up in contrast with those before operation(P<

关 键 词：翻修全髋置换术 臼杯假体松动 髋臼骨缺损 带翼加强髋臼杯 

分 类 号：R687.4[医药卫生—骨科学]