[Hip revision arthroplasty in massive bone loss of acetabulum with the use of reinforcement ring].

Tomasz Dorman, Krzysztof Kmieć, Ewa Pogonowicz, Marcin Sibiński, Marek Synder, Piotr Kozłowski
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Abstract

The aim of the study was the assessment of results after acetabular revision arthtoplasty with the use of reinforcement ring ReconShell (BBrown - Aesculap) and homogenous bone grafts. There were 49 patients in the study (42 women and 7 men) in the age from 30 to 88 years. The follow-up period ranged from 4 to 48 months. Before operation the mean Harris hip score was 31.14 and at last follow-up 71.64 points. Aseptic loosening of reconstruction ring was found in 3 patients. During next revision good integration of bone grafts, that were implanted into acetabulum at previous operation was found. In one hip revision of loose polietylen cup was performed. Three patient had early dislocation of hip endoprothesis, that were treated successfully in abduction casts. Next 2 patients had re-revision performed for recurrent dislocations. One patient had implants removal for septic loosening. Prolonged wound healing was noticed in 5 patients. Two patients had temporary and one permanent common peroneal nerve palsy. Two patients had temporary femoral nerve palsy. The use of reconstruction rings in massive bone loss of the acetabulum after cup loosening gives satisfactory clinical results. After the procedure patients have stabile joint that allows for weight bearing. Despite relatively high number of complications (most of which are temporary) this procedure is worth recommending.

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髋臼大量骨质流失的髋关节翻修置换术与加固环的应用。
本研究的目的是评估使用增强环ReconShell (brown - Aesculap)和均质骨移植物进行髋臼翻修关节成形术后的结果。研究中有49例患者(42例女性,7例男性),年龄从30岁到88岁。随访时间为4 ~ 48个月。术前Harris髋关节平均评分为31.14分,末次随访平均评分为71.64分。重建环无菌性松动3例。在下次翻修时,发现先前手术植入髋臼的骨移植物融合良好。一例髋部进行了松动聚乙烯杯的翻修。3例早期髋关节内假体脱位,均采用外展铸造成功治疗。接下来的2例患者对复发性脱位进行了重新翻修。1例患者因脓毒性松动而取出植入物。5例患者创面愈合时间延长。2例为暂时性腓总神经麻痹,1例为永久性腓总神经麻痹。2例出现暂时性股神经麻痹。重建环用于髋臼杯松动后大量骨丢失的临床效果满意。手术后患者有稳定的关节,允许负重。尽管并发症相对较高(大多数是暂时的),但该手术值得推荐。
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