两种翻修方式治疗Paprosky Ⅲ型重度髋臼骨缺损OA
Treatment of Paprosky type Ⅲ severe acetabular bone defects with two revision methods
目的:探讨钽金属垫块联合多孔生物钽杯、钛网打压植骨联合骨水泥假体翻修治疗Paprosky Ⅲ型重度髋臼骨缺损的中期临床疗效.方法:收集2012年7月至2019年3月接受手术治疗的重度髋臼骨缺损患者临床资料,其中男8例,女11例,均为单侧髋关节翻修;髋臼骨缺损分型均属于Paprosky Ⅲ型;其中采用钽金属垫块联合多孔生物钽杯翻修12例(A组)、钛网打压植骨联合骨水泥假体翻修7例(B组).观察比较两组患者手术时间、出血量及相关并发症,评估术前及随访X线影像,术前及随访终末采用Harris评分进行疗效评价.结果:A组手术时间(135.00±20.23)min 和术中出血量(828.57±213.81)mL,均少于 B 组的(162.86±16.07)min 和(1 557.14±439.16)mL,两组间差异有统计学意义(P＜0.05).随访时间2～12年,末次随访A组Harris评分由术前(36.25±6.88)分提升至(82.67±7.16)分,B组由术前(33.29±5.22)分提升至(79.29±5.62)分,差异均有统计学意义(P＜0.05).所有患者中仅1例出现术后假体周围骨折,3例出现下肢深静脉栓塞,其余无神经血管损伤、感染及早期假体松动发生.结论:钽金属垫块联合多孔生物钽杯与钛网打压植骨联合骨水泥假体治疗Paprosky Ⅲ型重度髋臼骨缺损均可获得满意的中期临床疗效.
Objective To investigate the mid-term clinical efficacy of two acetabular revision methods in the treatment of severe Paprosky type Ⅲ acetabular bone defects.Methods Clinical data of patients with severe acetabular defects who under-went surgical treatment were collected from July 2012 to March 2019,including 8 males and 11 females,all belong to Paprosky type Ⅲand underwent unilateral hip joint revision;12 cases(Group A)underwent revision using tantalum metal augment com-bined with porous biological tantalum cup,and 7 cases(Group B)underwent revision using titanium mesh compression bone grafting combined with cement prosthesis.Record the patient's surgical times,bleeding volumes,and complications,evaluate preoperative and postoperative X-rays as well as Harris scores.Results The average surgical time and intraoperative blood loss in Group A were(135.00±20.23)min and(828.57±213.81)mL,respectively.The Group B were(162.86±16.07)min and(1557.14±439.16)mL,respectively.The difference between two groups was statistically significant(P＜0.05).The follow-up period ranged from 2 to 12 years.At the end of the follow-up,the Harris score in Group A increased from(36.25±6.88)scores to(82.67±7.16)scores(P＜0.05);the Harris score in Group B increased from(33.29±5.22)scores to(79.29±5.62)scores(P＜0.05).Among all patients,only 1 case had postoperative periprosthetic fracture,3 cases had lower limb venous thrombosis,and the rest had no neurovascular injury,infection,or early prosthesis loosening.Conclusion the two acetabular revision meth-ods can achieve satisfactory mid-term clinical efficacy in the treatment of Paprosky type Ⅲ severe acetabular bone defects.
谢尚举;王拓;胡华辉;曹国平;吴权;楼红侃;叶春
宁波市中医院,浙江 宁波 315000||杭州市萧山中医院,浙江 杭州 311200杭州市萧山中医院,浙江 杭州 311200杭州市萧山中医院,浙江 杭州 311200杭州市萧山中医院,浙江 杭州 311200宁波市中医院,浙江 宁波 315000宁波市中医院,浙江 宁波 315000宁波市中医院,浙江 宁波 315000
医药卫生
关节成形术,髋,置换钽骨水泥
Arthroplasty,hip,replacementTantalumBone cement
《中国骨伤》 2026 (2)
164-171,8
浙江省医药卫生项目(编号:2020KY796)Zhejiang Medical and Health Project(No.2020KY796)
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