金属垫块结合Jumbo臼杯在人工髋关节翻修髋臼骨缺损重建中的应用研究
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作者Author单位AddressE-Mail
李锋侦 LI Feng-zhen 郑州市骨科医院, 河南 郑州 450052 Zhengzhou Orthopedics Hospital, Zhengzhou 450052, Henan, China  
司文腾 SI Wen-teng 郑州市骨科医院, 河南 郑州 450052 Zhengzhou Orthopedics Hospital, Zhengzhou 450052, Henan, China swteng516@163.com 
田爱利 TIAN Ai-li 郑州大学第三附属医院, 河南 郑州 450052 The Third Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, Henan, China  
周宇 ZHOU Yu 郑州市骨科医院, 河南 郑州 450052 Zhengzhou Orthopedics Hospital, Zhengzhou 450052, Henan, China  
陈明伟 CHEN Ming-wei 郑州市骨科医院, 河南 郑州 450052 Zhengzhou Orthopedics Hospital, Zhengzhou 450052, Henan, China  
期刊信息:《中国骨伤》2024年,第37卷,第5期,第464-469页
DOI:10.12200/j.issn.1003-0034.20220877
基金项目:
中文摘要:

目的:探讨金属垫块结合Jumbo臼杯在人工髋关节翻修髋臼骨缺损重建中的应用效果及影像学变化。

方法:回顾性分析2019年9月至2021年10月行人工髋关节翻修髋臼骨缺损重建术的83例患者临床资料,按手术方式不同分两组,42例采用金属垫块结合Jumbo臼杯方式进行翻修为A组,男26例,女16例,年龄44~72(60.57±4.62)岁;41例采用金属垫块联合骨水泥型臼杯进行翻修为B组,男22例,女19例,年龄42~71(58.74±4.25)岁。比较两组手术相关指标,术前及术后1、12个月Harris髋关节功能评分和疼痛视觉模拟评分(visual anagolue scale,VAS);根据X线片评估两组患者术前及术后12个月髋关节旋转中心高度、髋臼外展角、股骨偏心距以及影像学标准合格率,并比较两组并发症发生率。

结果:两组手术时间、术中出血量以及术后引流量比较差异无统计学意义(P>0.05)。两组均获得随访,时间12~36(25.36±3.59)个月。两组术后1个月Harris疼痛、功能、畸形评分及总分均高于术前(P<0.05),两组术后12个月Harris疼痛、功能、畸形、关节活动度评分及总分均高于术前和术后1个月(P<0.05),且术后12个月A组Harris各项评分及总分高于B组(P<0.05)。两组术后1、12个月VAS均依次降低(P<0.05),但两组各时间点VAS比较差异无统计学意义(P>0.05)。两组术后12个月股骨偏心距均升高(P<0.05),且A组高于B组(P<0.05);两组术后12个月旋转中心高度及髋臼外展角均降低(P<0.05),且A组旋转中心高度低于B组(P<0.05),但两组髋臼外展角比较差异无统计学意义(P>0.05)。A组的影像学合格率高于B组(P<0.05);两组并发症发生率比较差异无统计学意义(P>0.05)。

结论:金属垫块结合Jumbo臼杯治疗髋臼骨缺损可改善髋关节功能,恢复髋关节旋转中心、股骨偏心距以及髋臼外展角,临床效果明显。
【关键词】金属垫块  Jumbo臼杯  人工髋关节翻修  髋臼骨缺损
 
Application of metal cushion block combined with Jumbo cup in reconstruction of acetabular bone defect in revision of artificial hip joint
ABSTRACT  

Objective To investigate the application effect and imaging changes of metal cushion block combined with Jumbo cup in the reconstruction of acetabular bone defect after revision of artificial hip joint.

Methods Retrospective analysis was made on the clinical data of 83 patients who underwent revision acetabular bone defect reconstruction of the artificial hip joint in our hospital from September 2019 to October 2021. They were divided into group A and group B according to different surgical methods. There were 42 patients in group A,including 26 males and 16 females,aged from 44 to 72 years old with an average of (60.57±4.62) years,who underwent revision with metal cushion block and Jumbo cup. There were 41 patients in group B,including 22 males and 19 females,aged from 42 to 71 years old with an average of (58.74±4.25) years,who underwent revision with metal cushion block and bone cement mortar cup. The operation related indexes,Harris hip function score and visual analogue scale (VAS) of pain before operation,1 month and 12 month after operation were compared between two groups. The results of X-ray imaging examination (hip rotation center height,acetabular abduction angle,femoral eccentricity and imaging standard qualification rate) before and 12 month after operation were evaluated,and the incidence of complications was compared between two groups.

Results There was no significant difference in operation time,intraoperative bleeding volume and postoperative drainage volume between two groups (P>0.05). Both groups were followed up for 12 to 36 months with an average of (25.36±3.59) months. The scores of pain,function,deformity and Harris' total score in the two groups at 1 month after operation were higher than those before operation (P<0.05),and the scores of pain,function,deformity,joint activity and Harris' total score in two groups at 1 year after operation were higher than those before operation and 1 month after operation (P<0.05),and the above scores in group A were higher than those in group B at 1 year after operation (P<0.05). The VAS of two groups decreased successively at 1 month and 1 year after operation (P<0.05),but there was no significant difference in both groups at each time point (P>0.05). The femoral eccentricity increased in both groups at 1 year after operation (P<0.05),and group A was higher than group B (P<0.05). The height of rotation center and acetabular abduction angle decreased in both groups at 1 year after operation (P<0.05),and the height of rotation center in group A was lower than that in group B (P<0.05),but there was no significant difference in acetabular abduction angle between two groups (P>0.05). The imaging qualification rate of group A was higher than that of group B (P<0.05). There was no significant difference in the incidence of adverse reactions between two groups (P>0.05)..

Conclusion Metal cushion block combined with Jumbo cup in the treatment of acetabular bone defects can provide the hip joint function,and restore the hip joint rotation center,femoral eccentricity and acetabular abduction angle,with obvious clinical effect.
KEY WORDS  Metal cushion block  Jumbo cup  Revision of artificial hip joint  Acetabular bone defect
 
引用本文,请按以下格式著录参考文献:
中文格式:李锋侦,司文腾,田爱利,周宇,陈明伟.金属垫块结合Jumbo臼杯在人工髋关节翻修髋臼骨缺损重建中的应用研究[J].中国骨伤,2024,37(5):464~469
英文格式:LI Feng-zhen,SI Wen-teng,TIAN Ai-li,ZHOU Yu,CHEN Ming-wei.Application of metal cushion block combined with Jumbo cup in reconstruction of acetabular bone defect in revision of artificial hip joint[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(5):464~469
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