双锥面螺旋髋臼在髋关节置换术后髋臼侧翻修术中的应用

The application of double-cone spiral acetabular prosthesis in acetabular repair surgery after hip arthroplasty

目的探讨双锥面螺旋髋臼假体在初次人工全髋关节髋臼侧翻修术中的临床应用效果。方法对1996年7月~2010年8月收治的25例初次行全髋关节置换术后假体松动的患者行双锥面螺旋髋臼翻修。患者男性6例,女性19例,年龄57~81岁,平均(69.0±0.2)岁。Harris评分16~57分,平均43分。患者术前均行X线,CT等影像学检查,术中彻底清理髋臼并根据骨缺损情况行同种异体颗粒松质骨打压植骨。术后随访评价依据Harris评分系统,根据坎贝尔手术学所提供的诊断标准判断影像学上假体是否松动。结果术后切口均一期愈合,经过3~14年,平均4年的随防,髋关节功能良好,未发现髋臼假体松动,按Harris评分标准,优16例,良6例,可3例,优良率为95%。结论运用双锥面螺旋髋臼假体对初次行全髋关节置换术后松动的患进行翻修治疗,固定可靠、愈合快、能早期功能锻炼、并发症少、功能满意,是一种确切可靠的方法。

Objective To explore the clinical outcome of double-cone spiral acetabular prosthesis for treatment of acetabular repair surgery after total hip arthroplasty.Methods From July 1996 to August 2010,25 patients,6 males and 16females,who had suffered from acetabular prosthesis loosening after total hip arthroplasty primary were treated by doublecone spiral acetabular.The age of the patients ranged from 57 to 81 years old(average,69.0±0.2 years old),the mean preoperative Harris hip score was 43(16 to 57) points.Prior to surgery,anteroposterior and latreal radiography,and CT scan were done for all the patients.Care was taken to throughly debride the pothological soft tissue of the acetabular,and allograft-bone implantation for bone defects.The Patients were followed up and evaluated with Harris scoring system,the progress of prosthetic was assessed according to the radiography findings which based on Campbell's Operative Orthopaedics standed.Result All cases were followed up for 4(3 to 14) years,all the operative incision healed at the primary stage and satisfactory functional recovery and without prosthesis loosening.According to the Harris hip score system,excellent in 16 cases,good in 6 cases,poor in 3 cases,the excellent and good rate being 95%.Conclusion The treatment of acetabular prosthesis loosening after total hip arthroplasty primary with double-cone spiral acetabular prosthesis is recommended,because it is can give firm fixation,earlier functional exercise,more rapid recovery and fewer complication.