“杯上杯”技术治疗PaproskyⅢ型髋臼缺损的早期疗效观察

Early effect of“cup on cup”technique in the treatment of PaproskyⅢacetabular defect

目的评估“杯上杯”技术(去除钛环的钽金属翻修臼杯作为加强块)治疗PaproskyⅢ型髋臼缺损的早期临床效果。方法回顾性分析2010年1月—2016年12月于湖北省利川市人民医院骨一科行全髋关节翻修术,同时采用“杯上杯”技术治疗PaproskyⅢ型髋臼缺损的18例患者。其中男性11例,女性7例;年龄32~61岁,平均46.4岁。缺损原因退变14例,摔伤4例。单纯髋臼假体松动16例,髋臼假体松动伴脱位2例。记录患者手术时间、术中出血量、双下肢短缩程度以及患者术前和术后1、12个月VAS评分、Harris评分。利用骨盆正位X线片评估假体位置、有无假体松动、骨溶解情况,采用Harris量表评估髋关节功能。结果随访时间36~108个月,平均61.2个月。手术时间(152.5±20.3)min,术中失血量(782.5±156.9)mL,术后12个月VAS评分为(2.6±0.7)分,Harris评分为(87.3±12.1)分。患者均未出现感染、脱位、松动等并发症。结论“杯上杯”技术在全髋关节翻修术治疗PaproskyⅢ型髋臼缺损患者中,并发症少、安全性高、功能恢复好,值得临床推广。

Objective To evaluate the early clinical efficacy of the"cup-on-cup"technique(tantalum acetabular cup as reinforcing block)in the treatment of PaproskyⅢacetabular defects.Methods A retrospective analysis was performed on 18 patients with PaproskyⅢacetabular defect who underwent total hip arthroplasty in our hospital from Jan.2010 to Dec.2016 and were treated with"cup on cup"technique(tantalum acetabular cup as reinforcing block).Among them,11 were male and 7 were female,aged 32-61(46.4 on average)years.Injury mechanism:14 cases of degeneration and 4 cases of falling injury.There were 16 cases of acetabular prosthesis loosening and 2 cases of acetabular prosthesis loosening with dislocation.The prosthesis position,prosthesis looseness and osteolysis were assessed by pelvic X-ray,and the hip function recovery was assessed by Harris score.Results Patients were followed up for 36 to 108 months,with an average follow-up time of 61.2 months.The operation time was(152.5±20.3)min,the intraoperative blood loss was(582.5±156.9)mL,the VAS score was(2.6±0.7)points and the Harris score was(87.3±12.1)points at 12 months after operation.None of the patients had infection,dislocation,loosening or other complications.Conclusion The technique of"cup on cup"in the total hip arthroplasty for the treatment of PaproskyⅢacetabular defect has few complications,high safety,and good functional recovery,and it is worthy of clinical promotion.