髋关节翻修手术中髋臼缺损的重建方法  

Management of acetabular bone defect in revision hip arthroplasty

作　　者：尚希福 张晓琪 Shang Xifu;Zhang Xiaoqi(Department of Orthopaedics,the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital),Division of Life Science and Medicine,University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)骨科,中国科学技术大学生命科学与医学部,合肥230001

出　　处：《中华外科杂志》2024年第9期818-821,共4页Chinese Journal of Surgery

摘　　要：近年来髋关节翻修手术量呈增长趋势,髋臼缺损重建是关节外科医师面临的挑战。髋臼缺损重建的原则是实现假体和宿主骨间的初始稳定及长期稳定。随着手术技术、假体材料和翻修理念的更新,亟需新的髋臼缺损评估系统以满足临床需求。多孔表面非骨水泥半球形臼杯已成为目前临床应用的主流假体,金属垫块逐渐取代了结构性植骨,臼杯和垫块结合的组配式重建已展现良好的临床效果,结合牵张技术可用于髋臼离断等严重髋臼缺损的重建。打压植骨、超大臼杯、金属垫块、髋臼加强环罩、定制关节(包括定制三翼髋臼假体)、骨牵张技术等重建技术各有利弊,临床效果仍有待长期随访观察。The number of hip revision surgeries is expected to increase in recent years,and reconstruction of acetabular defects is a challenge for joint surgeons.The principle of reconstruction of acetabular defects is to achieve initial and long-term stability between the prosthesis and the host bone.With the development of surgical techniques,prosthetic materials,and revision concepts,there is an urgent need for new acetabular bone defect evaluation systems to meet clinical needs.The uncemented porous hemispherical cup has become the main prosthesis in clinical application,and metal augments are gradually replacing the structural allograft.Modular reconstruction combined cups and augments has shown favorable clinical results,which can be used for large acetabular defects with acetabular distraction technique,such as pelvic discontinuity.The advantages and disadvantages of impaction bone grafting,jumbo cups,metal augments,acetabular reinforcement rings,custom components(including custom triflanged acetabular components),and acetabular distraction technique still need to be observed in long-term follow-up.

关 键 词：关节成形术 置换 髋 髋臼 髋关节翻修术 髋臼骨缺损 骨重建 髋假体 

分 类 号：R687.4[医药卫生—骨科学]