中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (13): 1866-1872.doi: 10.3969/j.issn.2095-4344.2016.13.006

• 人工假体 artificial prosthesis • 上一篇    下一篇

保留髋臼杯骨水泥聚乙烯内衬置换的髋臼侧翻修

阿卜杜克热木•热夏提,任姜栋,阿斯哈尔江•买买提依明,曹  力,吾湖孜•吾拉木   

  1. 新疆医科大学第一附属医院关节外科,新疆维吾尔自治区乌鲁木齐市  830000
  • 收稿日期:2016-01-21 出版日期:2016-03-25 发布日期:2016-03-25
  • 通讯作者: 阿斯哈尔江?买买提依明,主任医师,副教授,新疆医科大学第一附属医院关节外科主任,新疆维吾尔自治区乌鲁木齐市 830000
  • 作者简介:阿卜杜克热木?热夏提,男,1987年生,新疆维吾尔自治区伊宁市人,维吾尔族,新疆医科大学第一附属医院关节外科在读硕士,主要从事关节疾病方面的研究。

Cementation of polyethylene liner into a retained stable cup in the acetabular revision

Abudukeremu•Rexiati, Ren Jiang-dong, Asihaerjiang•Maimaitiyiming, Cao Li, Wuhuzi•Wulamu   

  1. Department of Joint Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
  • Received:2016-01-21 Online:2016-03-25 Published:2016-03-25
  • Contact: Asihaerjiang?Maimaitiyiming, Chief physician, Associate professor, Department of Joint Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
  • About author:Abudukeremu?Rexiati, Studying for master’s degree, Department of Joint Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China

摘要:

文章快速阅读:

文题释义:

骨水泥聚乙烯内衬置换:又称双杯技术,最初主要应用于全髋关节置换翻修术中因髋臼杯原锁定机制损害、无法找到匹配的高交联聚乙烯内衬而难以实现单纯内衬更换时,因单纯聚乙烯内衬更换后内衬松脱率较高,目前在骨水泥聚乙烯内衬置换技术保留髋臼杯的翻修术中应用较广泛,但在选择聚乙烯内衬厚度及股骨头直径等方面有限制性。

人工髋关节髋臼侧翻修:全髋臼侧翻修创伤较大,会进一步丢失骨量,甚至会引起骨盆不连续,而且全髋臼侧翻修后恢复慢、并发症多。骨盆连续性、中断性骨缺损是人工髋关节翻修过程中髋臼侧翻修最难处理的问题,并发症的发生率高。可以采用钢板固定髋臼前后柱,或者使用髋臼加强环,并且在骨缺损处植骨的方法进行处理。  

 

背景:人工全髋关节置换关节翻修过程中虽然保留稳定性良好的髋臼杯骨水泥聚乙烯内衬置换比全髋臼侧翻修具有更多优势,但对于其临床效果,尤其是翻修后降低患者再次翻修率及延长假体寿命等方面目前仍存争议。
目的:探讨保留髋臼杯骨水泥固定聚乙烯内衬置换在人工全髋关节翻修过程中的临床效果及安全性。
方法:对2012年3月至2014年11月行保留髋臼杯骨水泥聚乙烯内衬置换的9例患者进行随访,男1例,女8例,平均年龄43.7岁,距离初次全髋关节置换时间平均为9.4年。随访患者翻修后髋关节Harris评分及假体X射线片,进一步评价保留髋臼杯骨水泥聚乙烯内衬置换的效果和安全性。

结果与结论:9例患者均获得随访,随访时间8-37个月。翻修前髋关节Harris评分为(49.54±18.28)分,末次随访髋关节Harris评分为(84.82±10.59)分,差异有显著性意义(t=6.377,P < 0.05)。其中1例因复发性假体脱位行再次翻修,其余患者未出现并发症,以再次翻修为终点,失败率为11%。提示保留髋臼杯骨水泥聚乙烯内衬置换是保留稳定性良好的髋臼杯的一种安全有效的修复方式。 

ORCID: 0000-0003-2322-9177 (阿卜杜克热木•热夏提)

关键词: 骨科植入物, 人工假体, 全髋关节置换, 翻修, 骨水泥固定, 内衬置换, 高交联聚乙烯, 早期随访

Abstract:

BACKGROUND: Although cementation of polyethylene liner into a well-fixed metal shell during the revision surgery has several advantages compared to total acetabular revision, there are some disputes about its clinical outcomes, especially regarding the re-revision rate and the prosthetic survivorship.
OBJECTIVE: To evaluate the clinical outcomes and safety of cementation of polyethylene liner into a well-fixed acetabular cup in the revision after total hip arthroplasty with retained stable cup.
METHODS: Between March 2012 and November 2014, nine patients underwent revision after total hip arthroplasty with cementation of polyethylene liner into a well-fixed acetabular cup. There were 1 male and 8 females, aged 43.7 years on average. The time was 9.4 years on average from the primary total hip arthroplasty to revision. Harris Hip Score and prosthesis X-ray films were compared after revision. The effects and safety of cementation of polyethylene liner into a well-fixed acetabular cup were further evaluated. 
RESULTS AND CONCLUSION: Nine patients were followed up for 8-37 months. The Harris hip scores before revision was (49.54±18.28) points previously, and (84.82±10.59) points during final follow-up (t=6.377, P < 0.05). One patient had re-revision surgery because of recurrent dislocation. There were not complications in other patients, resulting in failure rate of 11%. These results indicated that polyethylene liner cementation technique is safe and effective when the well-positioned and well-fixed acetabular cup retained.