Revision arthroplasty using an anti-protrusio cage for Paprosky type Ⅲ acetabular bone deficiency:a middle-term follow-up
10.3760/cma.j.issn.0253-2352.2013.05.012
- VernacularTitle:髋臼PaproskyⅢ型骨缺损髋臼加强杯翻修的中期疗效
- Author:
Qiang HUANG
;
Jing YANG
;
Bin SHEN
;
Zongke ZHOU
;
Pengde KANG
;
Fuxing PEI
- Publication Type:Journal Article
- Keywords:
Arthroplasty,replacement,hip;
Acetabulum;
Osteolysis;
Reoperation
- From:
Chinese Journal of Orthopaedics
2013;(5):507-513
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the middle-term results of anti-protrusio cage combining with allograft bone graft for revision arthroplasty of Paprosky type Ⅲ acetabular bone defect.Methods A retrospective analysis was done for 19 patients (20 hips) with Paprosky type Ⅲ acetabular bone defect who received acetabular revisions using anti-protrusio cage from January 2002 to December 2009.There were 11 males and 8 females,aged from 42 to 76 years (average,57.4 years).There were 7 hips (35％) of Paprosky type ⅢA acetabular bone defect,and 13 hips (65％) of type ⅢB.The follow-up time was (5.8±2.4) years.Hip function of patients was judged by Harris hip scores pre-and post-operation.The outcome of acetabular prostheses and bone grafts were assessed by radiologic evaluation.The five-year cage failure-free survival rate was assessed by Kaplan-Meier survivorship analysis.Results The Harris hip scores improved from preoperative 14.6±4.3 to 83.5±7.9 at the final follow-up.Lower limb discrepancy improved from preoperative (26.3±9.1) mm to postoperative (1.2±3.4) mm.The hip rotation center was reconstructed from preoperative(23.6±7.4) mm up-toward and (4.4±14.7) mm lateral-toward dislocation to inside Ranawat triangle.All the allograft bone was incorporated with host bone.None of cage displacement,screw fracture,progressive radiolucency and cement fracture was observed.Mild allograft bone resorption was observed in 3 hips (15％).There was no moderate or severe bone resorption found at the final follow-up.The five-year cage failure-free survival rate was 100％ (95％ CI,0.95-1.00).Conclusion The revision using anti-protrusio cage combined with allograft bone graft shows satisfying middle-term clinical and radiological results in the treatment of Paprosky type Ⅲ acetabular bone defect.
