[1]孙凯,孙群周△,阮成群,等.钛合金垫块结合生物型臼杯重建髋关节翻修中髋臼骨缺损16例[J].中国中医骨伤科杂志,2025,33(11):77-80.[doi:10.20085/j.cnki.issn1005-0205.251114]
　SUN Kai,SUN Qunzhou,RUAN Chengqun,et al.Reconstruction of Acetabular Bone Defects in Revision Total Hip Arthroplasty Using Titanium Alloy Augments with Biological Acetabular Cup:A Case Series of 16 Patients[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(11):77-80.[doi:10.20085/j.cnki.issn1005-0205.251114]
点击复制

钛合金垫块结合生物型臼杯重建髋关节翻修中髋臼骨缺损16例()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年11期
页码:
77-80
栏目:
临床报道
出版日期:
2025-11-15

文章信息/Info

Title:
Reconstruction of Acetabular Bone Defects in Revision Total Hip Arthroplasty Using Titanium Alloy Augments with Biological Acetabular Cup:A Case Series of 16 Patients
文章编号:
1005-0205(2025)11-0077-04
作者:
孙凯1; 孙群周2△; 阮成群2; 陈武林2; 李光明2; 牛焕章1△
1河南科技大学临床医学院(河南科技大学第一附属医院)(河南 洛阳,471000)
2河南省洛阳正骨医院(河南省骨科医院)
Author(s):
SUN Kai1; SUN Qunzhou2△; RUAN Chengqun2; CHEN Wulin2; LI Guangming2; NIU Huanzhang1△
1Clinical Medical College of Henan University of Science and Technology(The First Affiliated Hospital of Henan University of Science and Technology),Luoyang 471000,Henan China; 2Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital),Luoyang 471000,Henan China.
关键词:
髋关节;  再手术;  金属垫块;  髋臼骨缺损
Keywords:
hip joint;  reoperation;  metal pad;  acetabular bone defect
分类号:
R687.4
DOI:
10.20085/j.cnki.issn1005-0205.251114
文献标志码:
B
摘要:
目的:探讨钛合金垫块结合生物型臼杯治疗PaproskyⅢ型髋臼骨缺损的临床效果。方法:2019年5月至2024年11月对髋关节翻修术中采用钛合金垫块结合生物型臼杯进行髋臼侧重建治疗的16例(16髋)PaproskyⅢ型髋臼骨缺损患者的临床疗效进行回顾性分析,其中男9例(9髋),女7例(7髋); 平均年龄为66岁,术前改良Harris评分平均为(43.5±4.6)分。结果:16例患者均获随访,随访时间为6个月。末次随访改良Harris评分平均为(90.6±4.2)分; 术后髋关节旋转中心平均下移3.2 cm; 所有髋臼假体无松动或感染,影像学复查显示髋臼、垫块与骨床骨整合良好,臼杯、垫块无松动。1例术后出现腓总神经牵拉伤,经甲泼尼龙冲击治疗和电针刺激理疗,1周后恢复。结论:髋臼缺损重建的原则是应用外科手段重建髋臼环的完整性,以达到假体的初始稳定和长期稳定。应用钛合金垫块结合生物型臼杯进行翻修手术,可以重建髋臼环的完整,较大程度保留骨量、减少植骨,增加臼杯覆盖,恢复旋转中心,临床效果满意,是较为理想的治疗方法。
Abstract:
Objective:To investigate the clinical efficacy of titanium alloy augmentation combined with a biological acetabular cup in the management of Paprosky type Ⅲ acetabular bone defects.Methods:A retrospective analysis was conducted on 16 patients(16 hips)with Paprosky type Ⅲ acetabular defects who underwent acetabular reconstruction using titanium alloy augmentation and a biological acetabular cup during revision hip arthroplasty from May 2019 to November 2024.The cohort included 9 males(9 hips)and 7 females(7 hips),with a mean age of 66 years old.The average preoperative modified Harris score was(43.5±4.6)points.Results:The follow-up period after surgery was 6 months.The average modified Harris score at the last follow-up was(90.6±4.2)points.Postoperative radiographic evaluation demonstrated a mean inferior displacement of 3.2 cm in the hip rotation center,restoring physiological alignment.All acetabular components exhibited stable osseointegration without signs of loosening or infection.One case developed a common peroneal nerve traction injury postoperatively,which resolved completely within one week following methylprednisolone pulse therapy and electroacupuncture physiotherapy.Conclusion:The principle of acetabular defect reconstruction lies in restoring the continuity of the acetabular ring to achieve both primary stability and long-term fixation.The combination of titanium alloy augmentation and a biological acetabular cup effectively reconstructs acetabular integrity while maximizing bone preservation,minimizing graft requirements,optimizing cup coverage,and restoring biomechanical alignment.This technique demonstrates satisfactory clinical outcomes and represents an ideal therapeutic strategy for Paprosky type Ⅲ defects.

参考文献/References:

[1] SLOAN M,PREMKUMAR A,SHETH N P.Projected volume of primary total joint arthroplasty in the U.S.,2014 to 2030[J].The Journal of Bone and Joint Surgery:American Volume,2018,100(17):1455-1460.
[2] ENGH C A,MASSIN P,SUTHERS K E.Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components[J].Clinical Orthopaedics and Related Research,1990,257:107-128.
[4] 张先龙,蒋垚,陈云苏.人工髋关节外科学——从初次置换到翻修手术[M].北京:人民军医出版社,2009:163-164.
[5] 尚希福,张晓琪.髋关节翻修手术中髋臼缺损的重建方法[J].中华外科杂志,2024,62(9):818-821.
[6] 翁习生.人工髋关节翻修术中髋臼骨缺损的重建方法[J].中华骨与关节外科杂志,2022,15(1):10-18.
[7] REGIS D,SANDRI A,BONETTI I,et al.A minimum of 10-year follow-up of the Burch-Schneider cage and bulk allografts for the revision of pelvic discontinuity[J].The Journal of Arthroplasty,2012,27(6):1057-1063.
[8] SALEH K J,JAROSZYNSKI G,WOODGATE I,et al.Revision total hip arthroplasty with the use of structural acetabular allograft and reconstruction ring:a case series with a 10-year average follow-up[J].The Journal of Arthroplasty,2000,15(8):951-958.
[9] SHINAR A A,HARRIS W H.Bulk structural autogenous grafts and allografts for reconstruction of the acetabulum in total hip arthroplasty.Sixteen-year-average follow-up[J].The Journal of Bone and Joint Surgery:American Volume,1997,79(2):159-168.
[10] 王晗,贾古友,刘树民,等.Jumbo臼杯治疗全髋置换术后伴假体松动的假体周围骨折[J].中国矫形外科杂志,2020,28(16):1515-1517.
[11] 李锋侦,司文腾,田爱利,等.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.
[12] HE S,ZHU J,JING Y W,et al.Effect of 3D-printed porous titanium alloy pore structure on bone regeneration:a review[J].Coatings,2024,14(3):253.
[13] SUN Y,HU W C,WU C L,et al.Research progress on mechanical properties of 3D printed biomedical titanium alloys[J].Journal of Materials Engineering and Performance,2023,32(21):9489-9503.
[14] 王建朋,张维杰,马建兵,等.部分定制3D打印骨小梁金属块在修复严重髋臼骨缺损中的作用[J].中华骨与关节外科杂志,2023,16(1):17-24.
[15] NAGHAVI S A,TAMADDON M,GARCIA-SOUTO P,et al.A novel hybrid design and modelling of a customised graded Ti-6Al-4V porous hip implant to reduce stress-shielding:an experimental and numerical analysis[J].Frontiers in Bioengineering and Biotechnology,2023,11:1092361.
[16] RUSSELL S P,O'NEILL C J,FAHEY E J,et al.Trabecular metal augments for severe acetabular defects in revision hip arthroplasty:a long-term follow-up[J].The Journal of Arthroplasty,2021,36(5):1740-1745.
[17] 骆晓飞,王金良,王少华,等.金属垫块修复PaproskyⅢ型髋臼骨缺损在人工髋关节翻修术中的应用[J].中医正骨,2020,32(7):43-46.
[18] 张衡,马晓东,李博闻,等.3D打印定制假体及其在髋关节翻修髋臼重建应用中的研究进展[J].中国修复重建外科杂志,2024,38(11):1414-1420.
[19] 孙博,李科伟,王少华,等.3D打印金属垫块或一体化髋臼假体重建髋关节翻修术中骨缺损[J].中华骨科杂志,2025,45(2):94-101.
(收稿日期:2025-04-16)

备注/Memo

备注/Memo:
△通信作者 E-mail:zhengguluoyang@163.com(孙群周)
niuhuanzhang@126.com(牛焕章)
更新日期/Last Update: 2025-11-15