目的 总结多孔钽杯联合钽金属垫块翻修Paprosky Ⅲ型髋臼骨缺损的近期疗效。
方法 回顾分析2011年3月－2014年10月，在髋关节翻修术中采用多孔钽杯联合钽金属垫块修复Paprosky Ⅲ型髋臼骨缺损的8例（8髋）患者临床资料。男3例，女5例；年龄45～78岁，平均64岁。关节置换术后1个月～12年，平均5.94年行翻修术。其中髋臼假体周围骨溶解及假体松动翻修5例，髋关节置换术后感染二期翻修3例。术前Harris评分为41～54分，平均46.25分。
结果 术后患者切口均Ⅰ期愈合。8例患者均获随访，随访时间1～45个月，平均16.25个月；其中获随访1年以上3例，2年以上2例。患者术前患髋疼痛、跛行均明显改善。末次随访时，Harris评分为79～89分，平均83.75分。X线片复查示，随访期间臼杯及垫块周围未见进行性透亮线，无1例出现臼杯松动、移位及螺钉断裂，且臼杯及垫块周围有骨密度增强，骨长入良好。
结论 多孔钽杯联合钽金属垫块翻修Paprosky Ⅲ型髋臼骨缺损，可保证假体良好初始稳定性及覆盖，且能实现早期骨长入，获得满意近期疗效。
Citation：
郭江, 张忠杰, 李忠, 陈歌, 尹一然, 杨洪彬, 鲁晓波, 谭美云. 多孔钽杯联合钽金属垫块翻修Paprosky Ⅲ型髋臼骨缺损的近期疗效. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(5): 654-656. doi: 10.7507/1002-1892.20150141
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- 1. Telleria JJ, Gee AO. Classifications in brief:Paprosky classification of acetabular bone loss. Clin Orthop Relat Res, 2013, 471(11):3725-3730.
- 2. Galia CR, Macedo CA, Rosito R, et al. Femoral and acetabular revision using impacted nondemineralized freeze-dried bone allografts. J Orthop Sci, 2009, 14(3):259-265.
- 3. Iwase T, Masui T, Torii Y, et al. Impaction bone grafting for acetabular reconstruction:mean 5.5-year results in Japanese patients. Arch Orthop Trauma Surg, 2010, 130(4):433-439.
- 4. Regis D, Sandri A, Bonetti I, et al. A minimum of 10-year follow-up of the Burch-Schneider cage and bulk allografts for the revision of pelvic discontinuity. J Arthroplasty, 2012, 27(6):1057-1063. e1.
- 5. Pulido L, Rachala SR, Cabanela ME. Cementless acetabular revision:past, present, and future. Revision total hip arthroplasty:the acetabular side using cementless implants. Int Orthop, 2011, 35(2):289-298.
- 6. Schelfaut S, Cool S, Mulier M. The use of structural periacetabular allografts in acetabular revision surgery:2.5-5 years follow-up. Arch Orthop Trauma Surg, 2009, 129(4):455-461.
- 7. Van Kleunen JP, Lee GC, Lementowski PW, et al. Acetabular revisions using trabecular metal cups and augments. J Arthroplasty, 2009, 24(6 Suppl):64-68.
- 8. Moličnik A, Hanc M, Rečnik G, et al. Porous tantalum shells and augments for acetabular cup revisions. Eur J Orthop Surg Traumatol, 2014, 24(6):911-917.
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