“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

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。

Abstract:

[Objective] To evaluate the clinical outcome of cup-on-cup technique used in revision surgery for acetabular componentloosening with AAOS IIb acetabular bone defect. [Methods] A retrospective study was performed on 22 patients who underwent revisionhip arthroplasty by cup-on-cup technique in our hospital from February 2016 to April 2017. The clinical and radiological data were evalu-ated. [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 thecenter 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 satis-factory for AAOS IIb acetabular defect.