髋臼加固环改良全髋关节置换术-中期随访结果

S. Kwak, Y. Chun, K. Rhyu, D. Huh, M. Yoo, Y. Cho
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摘要

目的:评价髋臼加固环翻修全髋关节置换术的临床和影像学效果。材料和方法:在1997年至2005年期间,36例患者使用强化环和结构或碎片化同种异体移植物进行了36例髋臼翻修。根据AAOS分类,III型髋臼缺损34例,IV型髋臼缺损2例,术后平均随访7.2年。结果:Harris髋关节平均评分为92.3分,较术前评分明显提高。(p < 0.001)。失败5例,无菌性穆勒环松动1例,感染2例(5.4%),髋关节脱位2例(5.4%)。移植物植入和骨重塑在所有髋关节中都成功发生,但在无菌性松动的情况下,环固定在手术时不充分。如果将假体复位或松动归为失败病例,成功率为91.7%,平均随访7.2年。结论:三种加固环髋臼翻修术患者髋臼周围骨群重建良好,临床和影像学效果良好。为了获得良好的效果,术中应明确种植体的安全固定,并充分了解各种加固环的特点。
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Revision Total Hip Arthroplasty Using Acetabular Reinforcement Ring - Midterm Follow-up Result -
Purpose: To evaluate the clinical and radiographic outcomes of the revision total hip arthroplasty using the acetabular reinforcement ring. Materials and Methods: Thirty-six acetabular revisions were performed in 36 patients with use of the reinforcement ring and structural or morselized allograft, between 1997 and 2005, in thirty-six patients. According to the AAOS classification, thirty-four cases of acetabular defects were Ttype III, and two were Ttype IV. Mean follow-up period after surgery was 7.2 years. Results: The mean Harris hip score was 92.3, which was significantly increased compared with the preoperative score. (p<0.001). There were five failures: a case of aseptic loosening of Muller ring, two cases of infection (5.4%) and two cases of hip dislocation (5.4%). Graft incorporation and bone remodeling occurred successfully in all hips, but in the case of aseptic loosening in which the ring fixation had been inadequate at the time of surgery. The success rate was 91.7% with a mean follow-up of 7.2 years, if the cases of revision or loosening of the component were classified into failure cases. Conclusion: Patients treated with acetabular revision with three kinds of reinforcement ring had reconstitution of periacetabular bone stock as well as good clinical and radiographic results. For the good results, the secure implant fixation during the surgery should be confirmed and we should completely understand the characters of the each kinds of reinforcement rings.
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