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“杯叠杯”技术处理AAOS Ⅱb髋臼骨缺损

Cup-on-cup technique in revision surgery for acetabular component loosening with AAOS Ⅱb acetabular bone defect
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摘要 [目的]评价“杯叠杯”(Cup-on-cup)技术处理AAOS Ⅱb型髋臼骨缺损类型中的临床结果。[方法]回顾性分析2016年2月—2017年4月于本院行“杯叠杯”技术进行髋关节翻修的22例患者的临床资料。评估临床和影像学效果。[结果]所有患者均顺利完成手术,术中无血管、神经损伤等严重并发症。随访时间平均(5.3±1.1)年。与术前相比,末次随访时,患者Harris评分[(45.5±10.3) vs (90.4±10.6),P<0.05]、髋关节屈-伸(range of motion,ROM)[(78.2±13.6)°vs (103.3±20.4)°,P<0.05]、髋内-外旋ROM [(26.1±10.7)°vs (46.6±17.9)°,P<0.05]、疼痛VAS [(8.3±1.3) vs (3.1±0.4),P<0.05]均显著改善,双下肢长度差显著减小[(15.1±2.5) mm vs (4.4±1.6) mm,P<0.05]。影像方面,与术前相比,末次随访时,旋转中心(center of rotation,COR)纵向偏移[(47.2±10.5) mm vs (20.5±5.7) mm,P<0.05]、COR横向偏移[(15.5±8.4) mm vs (4.8±3.5) mm,P<0.05]均显著减小。[结论]“杯叠杯”技术处理AAOS Ⅱb型髋臼骨缺损类型的初步临床效果满意。 [Objective] To evaluate the clinical outcome of cup-on-cup technique used in revision surgery for acetabular component loosening with AAOS Ⅱb acetabular bone defect.[Methods] A retrospective study was performed on 22 patients who underwent revision hip arthroplasty by cup-on-cup technique in our hospital from February 2016 to April 2017.The clinical and radiological data were evaluated.[Results] All patients had the revision THA performed successfully,without vascular,nerve injury and other serious complications,and followed up for(5.3±1.1) years on an average.Compared with those preoperative,the Harris score [(45.5±10.3) vs(90.4±10.6),P<0.05],hip flexion-extension range of motion(ROM) [(78.2±13.6)° vs(103.3±20.4)°,P<0.05],hip internal-external rotation ROM [(26.1±10.7)° vs(46.6±17.9)°,P<0.05],pain VAS score [(8.3±1.3) vs(3.1±0.4),P<0.05],and the leg length discrepancy [(15.1±2.5) mm vs(4.4±1.6) mm,P<0.05] improved significantly at the latest follow up.Radiographically,compared with those preoperatively,both the vertical deviation of the center of rotation(COR) [(47.2±10.5) mm vs(20.5±5.7) mm,P<0.05],and the transvers deviation of COR [(15.5± 8.4) mm vs(4.8±3.5) mm,P<0.05] significantly reduced at the latest follow-up.[Conclusion] The preliminary clinical consequence of cup-on-cup technique is satisfactory for AAOS Ⅱb acetabular defect.
作者 李帅垒 潘建康 孙永强 LI Shuai-lei;PAN Jian-kang;SUN Yong-qiang(Department of Revision Joint Surgery,Luoyang Orthopedic Hospital of Henan Province,Zhengzhou 450000,China)
出处 《中国矫形外科杂志》 CAS CSCD 北大核心 2023年第24期2286-2289,共4页 Orthopedic Journal of China
关键词 全髋关节置换术 髋臼骨缺损 髋翻修置换术 “杯叠杯”技术 total hip arthroplasty acetabular bone defect revision hip arthroplasty cup-on-cup technique
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