共查询到20条相似文献，搜索用时 31 毫秒
1.
Kyung-Soon Park Jong-Keun Seon Keun-Bae Lee Sung-Kyu Kim Chee-Ken Chan Taek-Rim Yoon 《The Journal of arthroplasty》2017,32(2):503-509
Background
This study aims at determining the average long-term result of revision total hip arthroplasty (THA) using the acetabular reinforcement ring with a hook (ARRH) and bone grafting in severe acetabular bony defect. Expected 15-year survival of ARRH in revision THA is included in the study.Methods
Retrospective review of 48 patients (48 hips) with follow-up duration of average 11.4 years (range, 6.1-21.4 years) was conducted. At each follow-up, Harris hip score was used to assess functional outcome, and radiographic acetabular component osteolysis was measured by DeLee and Charnley classification. Bone defects were assessed preoperatively and intraoperatively using American academy of orthopedic surgeons and Paprosky classification. The common modes of ARRH failures were evaluated. Bone consolidation, presence of heterotopic ossification, and complications such as infection and dislocation were recorded.Results
The bone defects were varied and included cavitary, segmental, and combined defects without any pelvic discontinuity. Mean Harris hip score improved from 52.6 points preoperatively to 82.0 points postoperatively. Nine acetabular revisions and 3 stem revisions (2 concurrent with acetabular revisions and 1 isolated stem revision) were performed. There were 5 infected cases and 1 patient with recurrent dislocation. The 11.4-year survival of revision THA with ARRH was 71% as the end point for acetabular revision surgery for any reason. The expected 15-year survival of revision THA with ARRH was 60%. The most common failure mode of ARRH was superomedial migration followed by lateral migration.Conclusion
ARRH combined with bone grafting produces relatively good average long-term clinical results. 相似文献2.
Shinya Hayashi Shingo Hashimoto Koji Takayama Tomoyuki Matsumoto Kotaro Nishida Ryosuke Kuroda 《The Journal of arthroplasty》2017,32(5):1606-1611
Background
We identified preoperative predictors and size of acetabular bone defects for poor return to daily activity after revision total hip arthroplasty.Methods
Our analysis was based on outcomes of 140 cases of revision total hip arthroplasty, performed for any reason between May 2001 and March 2013. The Japanese Orthopaedic Association (JOA) score and body mass index (BMI) measured preoperatively, and the University of California Los Angeles (UCLA) activity score and JOA score measured at the 2-year follow-up were evaluated. Acetabular bone defects were classified according to the American Academy of Orthopaedic Surgeons grading system, with further classification of the location and severity of each acetabular bone defect. We compared preoperative clinical factors and postoperative clinical outcomes statistically.Results
We found a significant association between the number of revision surgeries and worse postoperative JOA scores and UCLA activity scores. There were significant differences in postoperative JOA scores and UCLA activity scores between patients with partial and global acetabular bone defects.Conclusion
Multiple revision surgeries and the size of the acetabular bone defect were predictors of both poorer clinical outcome and greater restriction in postoperative daily activities. Closer attention to the postoperative management of patients with a lower preoperative status is warranted. 相似文献3.
Background
We present the first medium- to long-term follow-up of revision total hip arthroplasty using impaction bone grafting (IBG) combined with the matte and collared Lubinus SP II stem for cases of severe osteolysis and stem loosening.Methods
Sixty-nine femoral revisions were identified for 67 patients consecutively operated with revision femoral arthroplasty using IBG and a cemented Lubinus SP II stem. The mean age was 69 years (standard deviation, 9.9). We retrospectively analyzed 68 cases (1 was lost to follow-up). At the time of the revision surgery, all had substantial femoral bone loss. Fifteen of the revisions were performed due to deep infection. The patients were analyzed by clinical score and radiography.Results
At follow-up, 4 femoral components (6%) had been rerevised or assessed as failure. Of these 4, 3 were assessed as mechanical failure, and 1 for dislocation; none was for infection. Three cups (4%) had been revised for dislocation; 1 of these also had a stem exchange. Three cases (4%) had been reoperated for a periprosthetic fracture in distal femur without stem exchange. Radiologic results were excellent and the clinical Merle d'Aubignè-Postel score had improved from a mean of 12.2 preoperatively to 17.5 at follow-up.Conclusion
IBG combined with the Lubinus SP II stem is safe and results in a low rate of periprosthetic fractures and dislocations. The medium- to long-term clinical result was excellent, with regeneration of living bone in the femur. 相似文献4.
Hernan A. Prieto Michael E. Kralovec Daniel J. Berry Robert T. Trousdale Rafael J. Sierra Miguel E. Cabanela 《The Journal of arthroplasty》2017,32(11):3488-3494
Background
Revision total hip arthroplasty (THA) is challenging specially in the presence of severe acetabular bone deficiency. We report the use of a highly porous revision shell augmented by structural allograft to provide structural support and coverage to the acetabular component.Methods
We identified 56 patients (58 hips) undergoing revision THA, where a trabecular metal revision cup was supported by structural allograft. Mean follow-up was 5.4 years (range 2-12 years). Preoperatively acetabular bone defects were classified as Paprosky 2A in 6 hips (10%), 2B in 12 hips (21%), 2C in 12 hips (21%), 3A in 11 hips (19%), and 3B in 17 hips (29%). Structural allograft configuration was classified as type 1 (flying buttress) in 13 hips, type 2 (dome support) in 23 hips, and type 3 (footings) in 17 hips, with 5 hips having combined configurations.Results
All hips showed evidence of union between the allograft and host bone at latest follow-up, 14 hips had partial resorption of the allograft that did not affect cup stability. Three acetabular components demonstrated failure of ingrowth. Survivorship-free from radiographic acetabular loosening as end point was 94% at 5 years. The 5-year survivorship with revision for any reason as end point was 90%.Conclusion
Trabecular metal shells combined with structural bone allograft in revision THA demonstrate excellent midterm survival, with 94% of acetabular components obtaining stable union onto host bone at 5 years. Allograft restored bone stock with minimal resorption, and when it occurred did not alter the survivorship of the acetabular component. 相似文献5.
Kareem M. Abdullah Nasir Hussain Samuel J. Parsons Matthew J.L. Porteous Amit Atrey 《The Journal of arthroplasty》2018,33(5):1481-1486
Background
We report an 11-year mean follow-up of the effectiveness of bone impaction grafting with bone and hydroxyapatite (HA) for large, uncontained acetabular defects in primary and revision hip surgeries.Methods
Over 5 years, 47 total hip arthroplasties with uncontained acetabular deficiencies were performed by augmentation using an impaction graft with 50:50 mixture of freeze-dried bone allograft and HA. Ten were primary total hip arthroplasties and 37 revision procedures. X-rays were taken postoperatively, 6 weeks, 3 months, and then annually to assess incorporation of the graft, radiolucent lines, resorption, or migration of components. Functional outcomes were assessed by annual pain and function parts of the Harris Hip Score.Results
At a mean follow-up of 10 years, the survivorship was 100%. All patients were accounted for; 6 had died. The Harris Hip Score for pain improved from 9 and 17 (primaries and revisions, respectively) to 39 and 41. For function, there was an improvement from 20 and 19 to 32 (both groups). There were lucent lines in 8 cases, 3 cups had minor/stable migration, and one cup had significant migration (>15 mm). Graft incorporation had occurred in 20 hips.Conclusion
This is the longest survivorship of bone impaction grafting with morcellised bone and HA substitute.Although 11-year survivorship, function and pain are excellent, radiological findings of lysis in 8 and migration in 4 cases may be of concern for the immediate future and will need close monitoring. Even in these cases, revision may be easier because of restoration of bone stock. 相似文献6.
Hiroyuki Makita Marcel Kerboull Yutaka Inaba Taro Tezuka Tomoyuki Saito Luc Kerboull 《The Journal of arthroplasty》2017,32(11):3502-3509
Background
The purpose of this study is to review our experience with Kerboull reinforcement device combined with bulk allograft for management of severe acetabular defects.Methods
We investigated the results of revision total hip arthroplasty (THA) in 65 hips of 59 patients (10 male, 49 female) with Paprosky type 3A or 3B acetabular bone defects. Functional outcome was assessed using the Merle d'Aubigne hip score. Post-operative radiographs were examined for evidence of cup loosening. The mean age at revision THA was 59.1 years (23-85) and mean follow-up duration was 11.2 years (2-15).Results
The Merle d'Aubigne hip score improved from 10.6 points (5-15) before surgery to 17.1 points (15-18) (P < .05) at the time of last investigation. In this series, mean coverage of the bone graft was 83.0% (34.6-100) of the loading portion in the horizontal plane on radiography immediately after revision. However, consolidation of the bone graft was completed within 12 months for all cases. There were 4 radiological failures due to acetabular aseptic loosening at a mean of 10.8 years (8-13) after index surgery; all 4 cases demonstrated massive bone loss that no part of the rounded plate could be placed on the host bone. Kaplan-Meier analysis showed that the 15.2-year survival rate was 85.1% (95% confidence interval 71-99) with re-revision surgery for any reason as the end point.Conclusion
Despite massive bone defects, we achieved favorable results for revision THA using bulk allograft and the Kerboull reinforcement device. 相似文献7.
Ahmed Nageeb Mahmoud Martin Sundberg Gunnar Flivik 《The Journal of arthroplasty》2017,32(5):1612-1617
Background
Porous metal augments have been used successfully for management of large acetabular defects during revision hip arthroplasty. The purpose of this study was to retrospectively review and compare the clinical and radiographic outcomes of porous metal augments in cemented and uncemented acetabular revisions, all performed at the same institution.Methods
Using our institutional clinical databases, the clinical and radiological outcomes of 104 cemented and 43 uncemented acetabular revisions with metal augments, performed between 2006 and 2015, were studied and compared. Acetabular augments were used when preoperative and intraoperative findings indicated the presence of large acetabular defects that can hinder the stability of the revision implants.Results
At a mean follow-up of 60.1 months (range 12.7-112.1), a total of 5 cups (3.4%), being 3 cemented (2.8%) and 2 uncemented (4.6%), had shown signs of aseptic loosening with cup and augment migration and 4 of these have been re-revised (2.7%). At final follow-up, the European Quality of Life-5 Dimensions for generic health, and the Hip disability and Osteoarthritis Outcome Score (HOOS) parameters had improved substantially without any significant difference between fixation techniques.Conclusion
Porous metal augments show comparable excellent radiographic and clinical mid-term outcomes when combined with cemented or uncemented cups in revision hip arthroplasty. 相似文献8.
Hazem A.H. Hosny Ahmed El-Bakoury Helmy Fekry Jonathan Keenan 《The Journal of arthroplasty》2018,33(5):1487-1493
Background
Several techniques have been described for management of severe acetabular bone defects during revision hip surgery including reconstructive cages. The purpose of this study is to analyze the survival and the mid-term clinical and radiological outcome using the Graft Augmentation Prosthesis (GAP II cage) (Stryker Orthopaedics, Mahwah, NJ) in addition to impaction grafting for acetabular defects in revision hip surgery.Methods
This is a retrospective review of all patients who underwent acetabular revision hip replacement using GAP II cage and impaction bone grafting between 2009 and 2013 at our institution. Twenty-six patients were included with a mean age of 71 years (49-91). According to Paprosky classification, 2 patients had type IIB defect, 4 had type IIC, and 12 had type IIIA, while 8 suffered from type IIIB defect. The clinical outcome was assessed using Oxford Hip Score. Plain radiographs were used to assess preoperative bone loss, postoperative implant migration, and the incorporation of the bone graft to host bone.Results
The average Oxford Hip Score improved from 11.3 (2-22) preoperatively to 32.2 (20-48) postoperatively. The revision free survivorship of this construct was 100% at mean follow-up of 49 months (30-78). Three hips had radiological failure of the implant with no clinical consequences.Conclusion
The use of GAP II cage with impaction bone grafting to reconstruct severe acetabular defects had encouraging mid-term results with low failure rate. Graft incorporation with restoration of bone stock may be beneficial should further revision surgery be needed. 相似文献9.
Kensuke Yoshino Tadashi Tsukeoka Yoshikazu Tsuneizumi Tae Hyun Lee Junichi Nakamura Masahiko Suzuki Seiji Ohtori 《The Journal of arthroplasty》2017,32(11):3495-3501
Background
Bone deficiency in revision total hip arthroplasty is a surgical challenge. The Murata-Chiba cup supporter (MC support ring) is an acetabular component supporter for a cementless porous-coated cup. The purpose of this study is to examine the clinical and radiographic outcomes of reconstruction of acetabular bone deficiency using iliac autografts supported by an MC support ring in a revision setting with minimum 15-year follow-up.Methods
Fifty-nine consecutive revision total hip arthroplasties (57 patients) using the MC support ring were followed for a minimum of 15 years. Nine hips had American Academy of Orthopaedic Surgeons type II deficiency and 24 had type III defects of the acetabulum. Clinical outcomes were evaluated using the Harris hip score. Radiographic evaluation included assessment for loosening and bone graft incorporation. Kaplan-Meier survival analysis was performed.Results
At a minimum 15-year follow-up (mean, 17.6 years), 32 patients (33 hips) were alive, 17 patients (18 hips) were deceased, and 8 patients (8 hips) were lost to follow-up. The mean Harris hip score improved from 44.3 to 77.2 at final follow-up. Four hips required reoperation due to deep infection (2 hips) and liner dissociation (2 hips), but no acetabular components were revised for aseptic loosening. Incorporation of the bone graft occurred in all cases. One unrevised patient had radiographic failure. Survivorship at 15 years with re-revision or radiographic failure as the end point was 90.6% (95% confidence interval, 83.0%-98.8%).Conclusion
The reconstruction of acetabular bone deficiency using autografts supported by an MC support ring provided satisfactory clinical and radiological results at 17.6 years postoperatively. 相似文献10.
Background
The purpose of this study is to evaluate the outcome of revision total hip arthroplasty using an uncemented deep profile jumbo acetabular component in patients who had been followed for a minimum of 10 years postoperatively.Methods
Between 1997 and 2001, 61 revision total hip arthroplasties were performed in 58 patients, with use of the +5 Deep Profile acetabular shell. The outcome with regard to retention vs re-revision of the acetabular component was determined for every hip. At a mean of 13 years (range 10-16) postoperatively, 30 patients (32 hips) were living. The Harris hip score, radiographic results, complications, and Kaplan-Meier survivorship were evaluated.Results
In the entire cohort of 61 hips, 4 acetabular components have been re-revised. Two shells were re-revised for sepsis: 1 shell was re-revised for aseptic loosening and 1 for recurrent dislocation. In the 32 hips followed for a minimum of 10 years postoperatively, 2 cups have been re-revised: 1 for aseptic loosening and 1 for recurrent dislocation. One additional shell was loose by radiographic criteria. With failure defined as re-revision for any reason, implant survival (95% confidence interval) was 92.6% (81.0-97.2) at 16 years. With failure defined as re-revision for aseptic loosening, implant survival was 97.4% (82.8-99.6) at 16 years.Conclusion
Revision total hip arthroplasty with the +5 Deep Profile acetabular component was associated with a good rate of survival at 16 years. 相似文献11.
Brian P. Gladnick Keith A. Fehring Susan M. Odum Michael J. Christie David K. DeBoer Thomas K. Fehring 《The Journal of arthroplasty》2018,33(2):500-504
Background
Custom triflange acetabular components are being increasingly used for the reconstruction of Paprosky type IIIB acetabular defects. However, midterm survivorship data are lacking.Methods
We queried the prospective registries at 2 high-volume revision centers for patients who had undergone revision total hip arthroplasty using a custom triflange component between 2000 and 2011. We identified 73 patients with minimum 5-year follow-up. These patients' records were reviewed to determine incidence of revision or reoperation, clinical performance, and radiographic stability. The mean follow-up was 7.5 years (range 5-12 years).Results
Fifteen of 73 triflange components (20.5%) were indicated for revision during the follow-up period, including 6 for instability (8%) and 8 for infection (11%). Twelve of 73 patients (16%) underwent reoperation for reasons other than failure of the triflange component. The median hip disability and osteoarthritis outcome score for joint replacement score at midterm follow-up was 85 (interquartile range 73-100). Only 1 of 73 implants was determined to be radiographically loose at midterm follow-up.Conclusion
Custom triflange reconstruction for severe acetabular deficiency is a viable option; however, complications are common and significant challenges remain for those that fail. 相似文献12.
Bradford S. Waddell Friedrich Boettner Alejandro Gonzalez Della Valle 《The Journal of arthroplasty》2017,32(3):919-923
Background
We present the early institutional experience with the use of impaction bone grafting, mesh augmentation, and cement fixation of an all-polyethylene cup for the treatment of Paprosky 3B acetabular defects during revision total hip arthroplasty.Methods
Between 2005 and 2014, 21 patients (9 men, 12 women) with Paprosky 3B acetabular defects who underwent revision total hip arthroplasty using this technique were reviewed clinically and radiographically. Average age and body mass index were 72.4 (range, 48-91) years and 24.5 (range, 18.9-31) kg/m2, respectively. All patients underwent revision for aseptic loosening. Surgical technique included the use of a peripheral mesh to contain the defect, followed by impaction of morselized fresh-frozen bone graft and cement fixation of a polyethylene cup.Results
Complications occurred in 6 patients (29%) including limp (2), sciatic nerve palsy that resolved (1), limb length discrepancy (1), and greater trochanteric fracture (1). After an average follow-up of 47 months (range, 13-128 months), the average Hospital for Special Surgery hip score was 35.5 (range, 20-40). Radiographic assessment revealed cephalad cup migration of 2.29 mm (range, 0-20 mm) and medial migration of 1.57 mm (range, 0-6 mm). One patient has radiographic loosening and no symptoms 120 months postoperatively. No patient returned to the operating room for a related reason or is scheduled to undergo acetabular re-revision surgery.Conclusion
Impaction bone grafting is a reliable technique for the treatment of Paprosky 3B acetabular defects. It restores bone stock like no other available for addressing these defects. Longer follow-up is required to assess potential deterioration of fixation. 相似文献13.
Brian P. Chalmers Cameron K. Ledford Michael J. Taunton Rafael J. Sierra David G. Lewallen Robert T. Trousdale 《The Journal of arthroplasty》2018,33(5):1501-1506
Background
Recurrent instability remains a challenge after revision total hip arthroplasty (THA). We report the outcomes of cementing a cementless dual mobility (DM) component into a stable acetabular shell for the treatment and/or prevention of instability in revision THA.Methods
Eighteen patients (18 THAs) undergoing revision THA with a specific monoblock DM construct cemented into a new acetabular component or an existing well-fixed component from 2011 to 2014 were retrospectively reviewed. Tumor prostheses and total femoral replacements were excluded. In 9 patients (50%), components were implanted specifically for recurrent dislocations. Mean age was 64 years; mean follow-up was 3 years. Patients underwent an average of 4 prior hip operations (range 2-6).Results
No cemented DM cups dissociated at the cement-cup interface. Three patients (17%) experienced a postoperative dislocation. One required a revision to constrained liner and 2 underwent open reduction with retention of the DM construct. Harris Hip Scores improved from 53 to 82 postoperatively (P < .001).Conclusion
Cementation of a monoblock cup DM construct, an off-label use as the construct is not specifically made for cementation, into a well-fixed acetabular component provides an alternative to enhance prosthetic stability in (1) recurrently dislocating THAs with well fixed, well-positioned acetabular components and (2) complex acetabular reconstructions in which constraint should be avoided. While not a perfect solution in this series, DM constructs provide a number of advantages including no added constraint at the interface and a large effective femoral head to diminish prosthetic impingement. 相似文献14.
Ronald E. Delanois Chukwuweike U. Gwam Nequesha Mohamed Anton Khlopas Morad Chughtai Arthur L. Malkani Michael A. Mont 《The Journal of arthroplasty》2017,32(9):2806-2809
Background
We are reporting on the minimum 5-year outcomes of patients who underwent revision total hip arthroplasty (THA) using a specific highly-porous titanium shell. We assessed (1) aseptic and all-cause survivorship; (2) functional outcomes; (3) complications; and (4) radiographic outcomes.Methods
Two hospital databases were evaluated for patients who underwent revision THA due to component instability or aseptic loosening using a cementless highly-porous titanium shell between September 2006 and December 2011. This yielded 35 patients who had a mean age of 61 years (range 14-88 years). Patients had a mean follow-up of 6 years (minimum 5 years). All-cause and aseptic survivorship of the shell was calculated. Functional outcomes were assessed using the Harris Hip Score. We determined the incidence of postoperative complications and performed radiographic evaluation of pelvic radiographs from regular office visits.Result
The aseptic survivorship of the acetabular component was 97% (95% confidence interval; 8.1-9.5). The all-cause survivorship of the acetabular component was 91% (95% confidence interval; 7.3-8.1). One patient had an aseptic failure and 2 patients had septic failures. The mean postoperative Harris Hip Score was 76 points (range, 61-91 points). Excluding the aseptic and septic failures, there was no osteolysis or progressive radiolucencies present on radiographic evaluation at final follow-up.Conclusion
At a minimum of 5-year follow-up, the highly-porous titanium acetabular revision shell has excellent survivorship and functional outcomes. Although long-term follow-up is needed to further monitor these implants, the results are promising and demonstrate that this prosthesis may be an excellent option for patients undergoing revision THA. 相似文献15.
Ashok S. Gavaskar Hitesh Gopalan Bhupesh Karthik Parthasarathy Srinivasan Naveen C. Tummala 《The Journal of arthroplasty》2017,32(3):872-876
Background
Total hip arthroplasty (THA) provides a successful salvage option for failed acetabular fractures. The complexity of arthroplasty for a failed acetabular fracture will depend on the fracture pattern and the initial management of the fracture. Our objective was to compare the midterm outcome of THA between patients who presented with failed acetabular fractures following initial surgical or nonsurgical treatment.Methods
Forty-seven patients underwent cementless THA ± acetabular reconstruction following failed treatment of acetabular fractures. Twenty-seven were initially treated by surgery (group A) and 20 had nonsurgical treatment (group B). Intraoperative measures, preoperative and follow-up clinical, radiological, and functional outcomes were compared between the 2 groups.Results
The mean surgical time, blood loss, and need for blood transfusion were significantly less in group A (P < .05). Acetabular reconstruction to address cavitary or segmental defects was needed in a significantly higher number of patients in group B (P = .006). Significant improvement in modified Merle d'Aubigne and Oxford scores was seen postsurgery in both groups. Acetabular component survival with aseptic loosening as end point was 98%. Overall survival rate with infection, revision, or loosening as end point was 93% at a mean follow-up of 7 years ± 17 months.Conclusion
THA for a failed acetabular fracture is greatly facilitated by initial surgical treatment. Although functional results and survivorship were similar in both groups, failed nonsurgical treatment in complex fractures is associated with migrated femoral head and extensive acetabular defects requiring complex acetabular reconstruction. 相似文献16.
Sujith Konan Donald S. Garbuz Bassam A. Masri Clive P. Duncan 《The Journal of arthroplasty》2017,32(3):915-918
Background
Revision hip arthroplasty for metal-on-metal arthroplasty (MOMA) in the presence of an adverse local tissue reaction (ALTR) has been associated with compromised outcomes. We hypothesized that revision of MOMA for painful micromotion of the cup, in the absence of ALTR, would have a more favorable outcome.Methods
We reviewed our database for Durom acetabular shell revision with minimum 24 months (24 months to 8 years) follow-up. Patients with a diagnosis of painful micromotion in the absence of pseudotumor was identified.Results
At mid-term follow-up, 71 patients had undergone revision of a Durom MOMA. Twenty-seven of these (38%) were for painful micromotion (9 total hip arthroplasty, 18 hip resurfacing) of the cup alone. Following revision surgery, all patients reported resolution of the preoperative pain, as well as satisfactory outcome measures (mean scores: The Western Ontario and McMaster Universities Arthritis Index [WOMAC] 84.6, oxford hip score 84.7, Short Form Health Survey (SF-16) 51, University of California, Los Angeles (UCLA) 7.3). Radiologically, all cases demonstrated osseointegration of the revision shells; 1 case had zone-3 radiolucency that was nonprogressive. One patient had a dislocation treated by closed reduction at 10 weeks.Conclusion
Revision MOMA for painful micromotion of the shell in the absence of ALTR is not similar to revision for ALTR and is associated with predictable improvement in pain and quality of life. 相似文献17.
Grant H. Young Matthew P. Abdel Richard L. Amendola Devon D. Goetz David G. Lewallen John J. Callaghan 《The Journal of arthroplasty》2017,32(11):3480-3483
Background
The authors and others have previously described the technique of cementing constrained liners into secure cementless acetabular shells and reported the short-term, average 3.9-year follow-up, using that technique. The purpose of the present study was to report the minimum 15-year follow-up of this same cohort.Methods
Between 1988 and 2000, 31 consecutive constrained liners of one design were cemented into well-fixed, well-positioned cementless acetabular shells at 3 institutions. Average age at surgery was 72 years (range, 31-91 years). Indications for the procedure were recurrent hip dislocation in 16 cases and intraoperative instability in 15 cases. Patients were evaluated for revision for failure of the device and revision for any reason.Results
At minimum 15-year follow-up, there was 1 patient lost to follow-up. Three hips (9.7%) were revised for failure of the device and 5 hips (16.1%) were revised for any reason.Conclusion
At minimum 15-year follow-up, considering the complexity of cases, there was excellent medium-term durability of this construct. 相似文献18.
Kevin C. Ilo Emma J. Derby Robert K. Whittaker Gordon W. Blunn John A. Skinner Alister J. Hart 《The Journal of arthroplasty》2017,32(5):1679-1683
Background
The R3 acetabular system used with its metal liner has higher revision rates when compared to its ceramic and polyethylene liner. In June 2012, the medical and healthcare products regulatory agency issued an alert regarding the metal liner of the R3 acetabular system.Methods
Six retrieved R3 acetabular systems with metal liners underwent detailed visual analysis using macroscopic and microscopic techniques.Results
Visual analysis discovered corrosion on the backside of the metal liners. There was a distinct border to the areas of corrosion that conformed to antirotation tab insertions on the inner surface of the acetabular shell, which are for the polyethylene liner. Scanning electron microscopy indicated evidence of crevice corrosion, and energy-dispersive X-ray analysis confirmed corrosion debris rich in titanium.Conclusion
The high failure rate of the metal liner option of the R3 acetabular system may be attributed to corrosion on the backside of the liner which appear to result from geometry and design characteristics of the acetabular shell. 相似文献19.
Kenichi Oe Hirokazu Iida Kohei Tsuda Tomohisa Nakamura Naofumi Okamoto Yusuke Ueda 《The Journal of arthroplasty》2017,32(3):908-914
Background
The purpose of this study was to identify the long-term durability of the Kerboull-type reinforcement device (KT plate) in acetabular reconstruction for massive bone defects, assessing the remodeling of structural bone grafts.Methods
This study retrospectively evaluated 106 hips that underwent acetabular reconstruction using a KT plate between November 2000 and December 2010. Thirty-eight primary total hip arthoplasties (THAs) and 68 revised THAs were performed, and the mean duration of clinical follow-up was 8 years (5-14 years). Regarding reconstructing the acetabular bone defects, autografts were used in 37 hips, allografts in 68 hips, and A-W glass ceramics in 2 hips.Results
One hip exhibited radiological migration and no revision for aseptic loosening. The mean Merle d'Aubigné Clinical Score improved from 7.5 points (4-12 points) preoperatively to 10.9 points (9-18 points) at the last follow-up. The Kaplan–Meier survival rate for radiological migration of primary and revised THAs at 10 years was 100% and 97% (95% confidence interval: 96%-100%), respectively. Bone remodeling was evaluated using the radiological demarcation at the bone-to-bone interface, and an improvement of 100% in primary THAs and 94% in revised THAs was observed.Conclusion
For massive bone defects, acetabular reconstruction using the KT plate with a structural bone grafting can yield successful results. 相似文献20.
Gulraj S. Matharu Andrew Judge David W. Murray Hemant G. Pandit 《The Journal of arthroplasty》2018,33(2):447-452