Recent evaluation of individual biological acetabular cup application in hip revision

doi:10.12307/2023.368

Abstract

Abstract: BACKGROUND: More and more patients received the total hip arthroplasty, and the acetabular loosening occurrence is increasing day and day. Commonly used operative methods include structural bone graft, morselized bone grafting and titanium mesh reconstruction, tantalum metal pads reconstruction, Jumbo cup and Cup-Cage technology.
OBJECTIVE: To summarize the clinical effect of the individual biological acetabular cup application in acetabular loosening after total hip arthroplasty and supply a feasible method for the hip revision.
METHODS: Eleven patients with acetabular loosening after the total hip arthroplasty undergoing acetabular revision used individual biological acetabular cups admitted at Pingdingshan Medical District Second Department of Orthopedics, the 989 Hospital of Chinese People’s Liberation Army Joint Logistics Support Force between March 2017 and March 2019 were included in this study. Of them, there were 7 men and 4 women, with the age of 55-71 years. The individual biological cups were used in the hip revision surgery and followed up for 3 years. Harris score, visual analogue scale score and absolute length difference of both lower limbs were recorded preoperatively and at final follow-up. X-ray films were observed to assess hip functional recovery and bone ingrowth.
RESULTS AND CONCLUSION: (1) All patients were underdone by the same doctor, followed up for 3 years and none lost. Among them, one case had symptoms of sciatic nerve, orally took mecobalamin tablets and recovered in 6 months. (2) Harris score, visual analogue scale score and absolute length difference of both lower limbs were significantly improved during the last follow-up (P < 0.05). (3) Last X-ray films showed good bone ingrowth. (4) These results imply that the individual biological acetabular cup application in acetabular loosening after total hip joint arthroplasty can restore the primary stability, restore ideal joint function and better bone ingrowth, and provide a feasible method for hip revision.

Key words: biological acetabular cup, revision, individual, bone defect, total hip arthroplasty, hip function recovery

CLC Number:

Zhou Hongxing, Zhang Baojian, Yuan Xiangsheng. Recent evaluation of individual biological acetabular cup application in hip revision[J]. Chinese Journal of Tissue Engineering Research, 2023, 27(22): 3521-3525.

Figures/Tables 4

References

[1] 钱涛,夏永法.老年全髋关节置换术中联合应用氨甲环酸和利伐沙班的临床研究[J].中医正骨,2019,31(1):10-13.
[2] 穆文博,胥伯勇,郭文涛,等.应用cup-cage技术重建PaproskyⅢB型髋臼骨缺损的早期疗效[J].中华骨科杂志,2017,37(7):393-400.
[3] 康志伟,张耀辉,杨自权.人工髋关节翻修术中髋臼骨缺损的分类和重建[J].中国骨伤,2018,31(9):874-879.
[4] 郭鹏年,董乐乐,张占阅.多孔钽金属加强块重建PaproskyⅡ、Ⅲ型髋臼骨缺损并发症的荟萃分析[J].中国矫形外科杂志,2018, 26(24):2260-2265.
[5] 程亮亮,赵德伟,杨磊,等.3D打印多孔钽金属加强块在成人DDH髋关节重建术中的应用[J].中华骨科杂志,2018,38(11):650-657.
[6] 张钟元,赵锦伟,黄相杰,等.髋关节翻修术中三D打印金属骨小梁垫块重建髋臼的近期疗效[J].中国修复重建外科杂志,2019, 33(12):1516-1520.
[7] 吴天昊,郭江,张才东,等.自体颗粒骨结合骨泥打压植骨治疗成人CroweⅢ型先天性髋关节发育不良伴髋臼缺损[J].中国组织工程研究,2017,21(22):3458-3463.
[8] 霍丽丽,颉朝阳,崔小雷.自体混合植骨治疗成人髋臼发育不良髋臼骨缺损[J].临床骨科杂志,2018,21(1):52-54.
[9] MORALES DE CANO JJ, GUILLAMET L, PEREZ PONS A. Acetabular reconstruction in paprosky type iii defects. Acta Ortop Bras. 2019; 27(1):59-63.
[10] 郭予立,胡奕山,刁喜财,等.金属垫块和颗粒植骨对全款关节翻修中髋臼骨缺损的应用效果[J].中国医学创新,2020,17(9):60-63.
[11] APRATO A, GIACHINO M, BEDINO P, et al. Management of Paprosky type three B acetabular defects by custom-made components: early results. Int Orthop. 2019;43(1):117-122.
[12] NTALOS D, BERGER-GROCH J, ROHDE H, et al. Implementation of a multidisciplinary infections conference affects the treatment plan in prosthetic joint infections of the hip: a retrospective study. Arch Orthop Trauma Surg. 2019;139(4):467-473.
[13] 陈宏亮,郭开今,陈向阳,等.在髋关节翻修中应用三D打印个性化生物型臼杯的疗效分析[J].骨科临床与研究杂志,2020,5(5):278-282.
[14] 崔宇韬,李祖浩,万谦,等.3D打印金属假体在关节外科的临床应用[J].中国修复重建外科杂志,2019,33(6):774-777.
[15] WANG YT, YANG XJ, YAN B, et al. Clinical application of three-dimensional printing in the personalized treatment of complex spinal disorders. Chin J Traumatol. 2016;19(1):31-34.
[16] ZHENG W, CHEN C, ZHANG C, et al. The Feasibility of 3D Printing Technology on the Treatment of Pilon Fracture and Its Effect on Doctor-Patient Communication. Biomed Res Int. 2018;2018:8054698.
[17] 刘曦明,曾文波.3D打印技术在骨盆髋臼骨折手术治疗中的研究进展[J].创伤外科杂志,2018,20(1):1-5.
[18] 郭宇,王凌,丁育健,等.3D打印钛合金骨小梁金属臼杯联合植骨重建髋臼骨缺损的早期疗效[J].实用骨科杂志,2020,26(6):491-494.
[19] 吴毅华,卢长巍,梁仁,等.3D打印技术在PaproskyⅢ型髋臼翻修中的临床应用[J].河北医学,2020,12(12):2036-2040.
[20] 吴敏,官建中,肖玉周,等.3D打印技术辅助经皮撬拨空心钉内固定治疗移位的跟骨关节内骨折[J]中国修复重建外科杂志,2017, 31(11):1316-1321.
[21] 姚坚,丁海.计算机导航及机器人技术辅助膝关节置换术的研究进展[J].中国修复重建外科杂志,2017,31(1):110-115.
[22] 陈宣煌,余正希,吴长福,等.Quadrant系统下3D打印导航模块辅助腰椎精准植钉的应用研究[J].中国修复重建外科杂志,2017, 31(2):203-209.
[23] COLO E, RIJNEN WH, SCHREURS BW. The biological approach in acetabular revision surgery: impaction bone grafting and a cemented cup. Hip Int. 2015;25(4):361-367.
[24] 马超,唐化羽.生物型与骨水泥型假体全髋关节置换术治疗老年移位型股骨颈骨折的疗效分析[J].创伤外科杂志,2021,23(4):301-304.
[25] SCHIFFNER E, LATZ D, THELEN S, et al. Normal CRP and WBC values in total hip arthroplasty (THA) with signs of loosening. Do we need a joint aspiration? J Clin Orthop Trauma. 2019;10(3):566-570.
[26] OOMMEN AT, KRISHNAMOORTHY VP, POONNOOSE PM, et al. Fate of bone grafting for acetabular defects in total hip replacement. Indian J Orthop. 2015;49(2):181-186.
[27] KOKUBO Y, OKI H, SUGITA D, et al. Long-term clinical outcome of acetabular cup revision surgery: comparison of cemented cups, cementless cups, and cemented cups with reinforcement devices. Eur J Orthop Surg Traumatol. 2016;26(4):407-413.
[28] 陈雷雷,洪郭驹,林天烨,等.同种异体颗粒骨打压植骨联合不同类型假体在严重髋臼骨缺损翻修中的应用[J].中国修复重建外科杂志,2020,34(3):341-346.
[29] 康朋,张方新,买合木提·亚库甫,等.3D手术模拟测量Crowe Ⅳ型发育型髋关节发育不良的真实髋臼形态[J].中国组织工程研究, 2020,24(36):5749-5754.
[30] 万安营,唐淼,刘忠堂,等.高位全髋关节置换治疗Crowe Ⅱ和Ⅲ型成人髋臼发育不良[J].中国矫形外科杂志,2020,28(1):36-40.
[31] 杜伟斌,王利祥,沈福祥,等.钻取式柱状自体髂骨植骨术应用及供骨区术后并发症的临床分析[J].中国骨伤,2018,31(5):446-451.