双活动度髋臼杯治疗全髋关节置换术中的不稳定性的效果

Mohamed Gamal El Din El Ashhab, Fahim Ali Mandour, Hesham Ali El Attar
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摘要

:背景:翻修全髋关节置换术(THA)后脱位仍是术后最常见、最令人担忧的并发症之一。双活动性(DM)髋臼组件可降低高风险患者术后不稳定的风险,无论是初次髋关节置换术还是翻修髋关节置换术均是如此。本研究旨在评估DM髋臼杯(DMC)治疗髋关节置换术不稳定性的效果。方法:这项前瞻性研究纳入了 20 名髋内收肌功能不全患者,他们均接受了使用双活动度髋臼杯的全髋关节置换术。对受累髋关节进行全面的局部检查和放射学评估,以确保模板的精确性。 在 6 周、3 个月、6 个月和最后一次随访时,使用 Harris 髋关节评分(HHS)对患者进行临床评估。在随后的随访检查中,为所有患者拍摄标准的 X 光片,以检查组件的位置或移位、骨溶解和松动,以及经股骨截骨术(如果使用)的结合情况。结果:关于假体,3 名(15.0%)患者使用了无骨水泥杯-无骨水泥柄,9 名(45.0%)患者使用了有骨水泥杯-无骨水泥柄,8 名(40.0%)患者使用了有骨水泥杯-有骨水泥柄。哈里斯髋关节评分随着术后时间的推移而提高。与术前相比,6周后、6个月后和1年后的HHS明显提高。结论:使用 DMC 是预防髋关节置换术不稳定的有效技术。使用 DMC 取得的临床效果相当令人满意,与其他技术相比,并发症的发生率明显降低。
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Outcome of dual mobility Acetabular cup for instability in total hip Arthroplasty
: Background: Dislocation after revision total hip arthroplasty (THA) continues to be one of the most common and concerning complications after the procedure. Dual-mobility (DM) acetabular components decrease the risk of post-operative instability also in high-risk patients, both in primary and revision hip arthroplasty. This study aimed to evaluate the outcome of DM acetabular cup (DMC) for instability in THA. Methods: This prospective study included 20 patients with Hip abductor insufficiency underwent total hip replacement using dual mobility cup. Complete local examination of the involved hip joint and radiological evaluation to ensure precise templating The Harris hip score (HHS) is used for clinical evaluation of patients at 6 weeks, 3months, 6 months, and the last follow-up. Standard radiographs are taken for all patients at subsequent follow-up examinations to examine component position or migration, osteolysis and loosening, and union of transfemoral osteotomy if used. Results: Regarding the prothesis, Cementless cup-Cementless stem was used in 3 (15.0%) patients, Cemented cup-Cementless stem was used in 9 (45.0%) patients and Cemented cup-Cemented stem was used in 8 (40.0%) patients. Harris hip score is improved over time postoperatively. HHS was significantly higher after 6 wks., after 6 months and after 1 years compared to preoperative HHS. Conclusion: the use of DMC has been found to be an effective technique for preventing hip arthroplasty instability. The clinical outcomes achieved with DMC were quite satisfactory, and the incidence of complications was significantly lower compared to other techniques.
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