Application of “reinforced concrete” in acetabular reconstruction

doi:0.3969/j.issn.2095-4344.2013.04.005

Abstract

Abstract:

BACKGROUND: In total hip arthroplasty, acetabular defects are common, for the reconstruction of a stable and solid acetabulum, the acetabular reconstruction is often required during the replacement process.
OBJECTIVE: To investigate the early effect of the short term results of titanium mesh fixed by screws combined with a cemented acetabular cup in acetabular reconstruction.
METHODS: Twenty-three patients treated with acetabular reconstruction by screw fixed titanium mesh combined with a cemented acetabular cup were selected. The pain history was 1 to 3 years. Harris scores before operation were 20-48 with an average score of 34. X-ray plain film was used to evaluate theacetabular prosthesis loosening standards after reconstruction for the radiographic evaluation and Harris score of regular follow-up.
RESULTS AND CONCLUSION: All the patients were followed-up for 1-3 years and average in 24 months without losing. The Harris score at 3 months after operation was higher than that before operation, and the hip activity at 2 years after operation was higher than that before operation, and the difference was significant (P < 0.05). Two patients still had leg length discrepancy, one patient with dislocation after squatting, and recovered after conservative treatment. The last follow-up showed there were no early infection, dislocation and pelvic discomfort. Radiographic results showed that there was no aseptic loosening and displacement of the acetabular cap and there was no fracture on titanium mesh. Screw fixed titanium mesh combined with a cemented cup is satisfactory process in the treatment of hip revision in over 65 years old patients, and the long-term effects are needed to be further followed-up and observed.

Key words: bone and joint implants, artificial prosthesis, cemented acetabular cup, titanium mesh, hip joint, acetabular prosthesis, acetabular defects, acetabular reconstruction, prosthetic replacement, screws, internal fixation, hip revision

CLC Number:

R318

Wang Zi-fu, Shang Xi-fu. Application of “reinforced concrete” in acetabular reconstruction[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(4): 594-598.

Figures/Tables 2

References

[1] Bozic KJ, Kurtz SM, Lau E, et al. The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am. 2009;91(1):128-133.

[2] Zhou YG, Zhang Q, Wang Y. Reconstruction of the severe acetabular bone defect by using metal mesh and impaction bone grafting technique. Zhonghua Wai Ke Za Zhi. 2009; 47(3):172-176.

[3] Kawanabe K,Akiyama H,Onishi E,et al. Revision total hip replacement using the Kerboull acetabular reinforcement device with morsellised or bulk graft：results at a mean follow up of 8.7 years.J Bone Joint Stag Br. 2007;89(J):26-31.

[4] Zivkovic I, Gonzalez M, Amirouche F. The effect of under-reaming on the cup/bone interface of a press fit hip replacement. J Biomech Eng. 2010;132(4):041008.

[5] Qiu XG. Beijing: The Publishing House of People’s Health.2009. 邱贵兴.人工髋关节的翻修、股骨骨缺损重建.髋关节置换并发症的诊断与治疗[M].北京:人民卫生出版社,2009.

[6] Chen T,Shang XF,Hu F,et al.Linchuang Guke Zazhi. 2010; 13(5):542-544. 陈涛,尚希福,胡飞,等.机械性预防下肢深静脉血栓在全髋置换术后患者中的作用[J].临床骨科杂志,2010,13(5):542-544.

[7] Luo SL, Yin F. Shiyong Linchuang Yixue. 2008;9(6):132. 罗树林,尹峰.全髋翻修术中严重髋臼缺损重建的研究进展[J].实用临床医学,2008,9(6):132.

[8] d'Aubigné RM, Postel M.The classic: functional results of hip arthroplasty with acrylic prosthesis. 1954. Clin Orthop Relat Res. 2009;467(1):7-27.

[9] van Biezen FC, van Gool RA, Reijman M,et al. Clinical outcomes of total hip arthroplasty after previous hip arthrodesis. Ned Tijdschr Geneeskd. 2007;151(39): 2148-2153.

[10] Fernandez-Fairen M, Murcia-Mazón A, Torres A,et al. Is total hip arthroplasty after hip arthrodesis as good as primary arthroplasty.Clin Orthop Relat Res. 2011;469(7):1971-1983.

[11] Alexa O, Popia I, Ciornohac F, P?duraru F, et al. Primary total hip arthroplasty in bilateral acetabular protrusion, case report. Rev Med Chir Soc Med Nat Iasi. 2008;112(2):427-431.

[12] Niu SZ, Chen JY, Zhou YG, et al. Shandong Yiyao. 2009; 49(30):35-36. 牛士贞,陈继营,周勇刚,等.全髋关节翻修术后髋臼旋转中心变化对髋关节稳定性的影响[J].山东医药,2009,49(30):35-36.

[13] Lian YY, Pei FX, Cheng JQ, et al. Zhonghua Yixue Zazhi. 2007;87(23):1603-1606. 廉永云,裴福兴,程惊秋,等.金属网罩结合异体骨打压植骨修复髋臼骨缺损[J].中华医学杂志,2007,87(23):1603-1606.

[14] Garcia-Cimbrelo E, Tapia M, Martin-Hervas C. 1-lultisliee computed tomotgraphy for evaluating aeetabular defects in revision THA.Clin Orthop.2007;463:138-143.

[15] Voigt C, Klohn C, Bader R, et al. Finite element analysis of shear stresses at the jmplant-bone jnterface Of an acetabular press-fit cup during impingement.Biomed 1-ech(Berl). 2007; 52(2):208-215.

[16] Banskota AK, Shrestha SP, Banskota B, et al. Hip arthrodesis in children: A review of 28 patients.Indian J Orthop. 2009; 43(4):383-388.

[17] Lia YY, Pei FX，Cheng JQ,et al.Reconstruction of acetabular defect with wire mesh and impacted bonegraft in cemented acetabular revision．Zhonghua Yi Xue Za Zhi.2007;87(23): 1603-1606.

[18] Huang DY,Zhou YX,Xu H,et al.Zhongguo Jiaoxing Waike Zazhi.2007;15(23):1781-1784. 黄德勇,周乙雄,徐辉,等打压植骨结合金属网重建全髋关节翻修术中髋臼侧严重骨缺损[J].中国矫形外科杂志,2007,15(23): 1781-1784.