Jumbo金属臼杯治疗初次全髋置换术后伴假体松动的髋臼假体周围骨折
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1.济宁市第二人民医院;2.天津市天津医院

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济宁市科技助推新旧动能转换计划(编号:2017SMNS014)


Outcome of post-operative periprosthetic acetabular fractures treated by Jumbo cups
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1.Jining Number 2 People'2.'3.s Hospital;4.Tianjin Hospital

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    摘要:

    [目的]本研究评估Jumbo金属臼杯处理初次全髋置换术后伴假体松动的髋臼假体周围骨折的治疗效果。[方法]回顾性分析2013年7月至2018年1月期间手术治疗的全髋关节置换术后伴假体松动的髋臼假体周围骨折患者9例,其中男性1例,女性8例,年龄32~76岁,平均(68.72±8.03)岁。按照Paprosky髋臼假体周围骨折分型,Ⅲb型4例,Ⅳa型4例,Ⅳb型1例。术中选择使用较末次磨挫大1~2mm的Jumbo金属臼杯并适当螺钉固定。采用疼痛视觉模拟评分(VAS)评价翻修术后疼痛情况,采用Harris评分评估术后患者髋关节功能,行双髋正位X线观察臼杯位置及骨折愈合情况。[结果]9例患者手术顺利且均获得良好随访,平均随访时间(24.89±10.32)个月,平均手术时间(104.57±23.89)min;平均术中出血量(245.38±85.89)ml。随术后时间推移,患者疼痛逐渐缓解,患侧髋关节功能锻炼持续改善,VAS评分显著降低(P<0.05),髋关节Harris评分显著增加(P<0.05)。术后影像学显示髋臼骨折均愈合良好,骨折愈合时间(16.38±2.01)周,髋臼假体位置良好,未见假体松动、移位。[结论]对于初次全髋置换术后伴假体松动的髋臼假体周围骨折,使用Jumbo金属臼杯既可满足骨折及假体牢靠固定,又可使翻修术操作简单有效,是可行的治疗方案。

    Abstract:

    [Objective] To evaluate the clinical outcome of post-operative periprosthetic acetabular fractures treated by Jumbo cups. [Methods] A retrospective study was conducted on 9 patients who underwent surgical treatment from January 2013 to January 2018, including 1 males and 8 females aged 32~76 years with a mean of (68.72±8.03) . According to the Paprosky classification of periprosthetic acetabular fracture, there are 4 cases of type Ⅲb, 4 cases of type Ⅳa, 1 case of type Ⅳb. Jumbo cups and various directions of cup screws were chosen to used. The visual analogue scale(VAS)for pain and Harris hip score were used for evaluation of the clinical consequences. [Results] All the 9 patients had surgical procedures conducted successfully without serious perioperative complications. The follow up period lasted for 23~77 months. The mean surgical time was(104.57±23.89)mins, and the mean blood loss was(245.38±85.89)ml. As time went post?operatively, the VAS score significantly decreased (P<0.05), while the Harris hip score significantly increased (P<0.05). Regarding to radiographic assessment, the periprosthetic acetabular fractures healed and the cup well fixed. All the patients achieved bony healing of the fractures with time of(16.38±2.01)weeks. [Conclusion] The use of Jumbo cups and various directions of cup screws is effective choice for treatment of the post-operative periprosthetic acetabular fractures with cup unstable.

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  • 收稿日期:2019-12-23
  • 最后修改日期:2020-01-21
  • 录用日期:2020-03-20
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