髋臼突出症全髋关节置换术:系统综述。

Sajid Ansari, Kshitij Gupta, Tushar Gupta, Balgovind S Raja, Pranav J, Roop Bhushan Kalia
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引用次数: 0

摘要

股骨头向髋臼异常突出(Protrusio acetabuli)需要进行全髋关节置换术(THA)。本系统性综述旨在对现有证据进行全面分析,评估治疗效果,比较手术技术,并确定未来研究课题,同时改进循证决策,改善患者的治疗效果。我们对 PubMed、Embase、Cochrane Library 数据库和 Scopus 图书馆进行了全面的系统性检索,提取了描述 THA 治疗髋臼突出技术的文章。最初的搜索产生了 751 条结果。经排除后,共纳入 18 篇文章。其中 8 篇为前瞻性研究,10 篇为回顾性研究。共有 783 例髋关节接受了手术,患者平均年龄为 60 岁;80% 的女性患者大多患有炎症性关节炎,随访时间为 8.86 年(2-15.4 年)。使用带骨移植的非骨水泥髋臼杯进行 THA 取得了良好的疗效,但对股骨侧的疗效还没有结论。可以得出的结论是,恢复解剖学上的髋关节旋转中心是取得良好疗效的关键,而且在使用非骨水泥髋臼杯和植骨时,植入物的存活率更高非常重要。此外,除非万不得已,否则不建议使用螺钉增强固定。最常见的并发症是无菌性松动和异位骨化。前者需要进行翻修,后者则采取保守治疗。
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Total Hip Arthroplasty in Protrusio Acetabuli: A Systematic Review.

Protrusio acetabuli, or abnormal protrusion of the femoral head into the acetabulum, requires performance of a total hip arthroplasty (THA) for which various reconstruction techniques and outcomes have been described. The aim of this systematic review is to provide a comprehensive analysis of the current evidence, evaluate treatment efficacy, compare surgical techniques, and identify topics for future research along with improving evidence-based decision-making, improving patient outcomes in the management of this condition. A thorough systematic review of the PubMed, Embase, Cochrane Library databases, and Scopus library was conducted, and articles describing techniques of THA for treatment of protrusion acetabuli were extracted. The initial search generated 751 results. After exclusion, 18 articles were included. Of these, eight were prospective studies and 10 were retrospective. Surgery was performed on 783 hips with a mean age of 60 years; 80% of females who mostly had inflammatory arthritis were followed up for 8.86 years (range, 2-15.4 years). Good outcomes have been achieved with THA using uncemented cups with bone graft; however, no conclusion could be drawn with regard to the femoral side. It can be concluded that the concept of restoration of the anatomical hip center of rotation is paramount for good outcome and better survival of the implant is important when using uncemented cups with a bone graft. In addition, screw augmentation for fixation is not recommended unless absolutely necessary. The most common complications were aseptic loosening and heterotopic ossification. While the former required revision, conservative management was administered for the latter.

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