Excellent Midterm Results of Triflange Patient Matched Implants for Extensive Acetabular Bone Defect
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Reconstruction of extensive acetabular bone defects is one of the most challenging problems encountered by arthroplasty surgeons. Triflange patient matched implants (PMI) offer the potential advantages of immediate, rigid fixation with a superior individualized fit. The purpose of this study was to evaluate the clinical and radiographic midterm results of PMI in extensive acetabular defect reconstruction. Materials and Methods: The current prospectively designed retrospective review examined 13 consecutive patients (5 males and 8 females) with a mean age of 69 years undergoing revision hip arthroplasty with Paprosky type 3B acetabular defects reconstructed using PMI between October 2011 and December 2016. A successful result was defined as a postoperative increase in Harris hip score (HHS) of >20 points with a radiographically stable implant (assessed with hip X-rays) and no need for additional acetabular reconstruction. Results: Twelve out of the 13 patients in the study were available for follow-up with mean duration of 50 months. One patient died during the study period due to an unrelated cause. The mean HHS increased from 41 to 82 points. Eleven out of 12 acetabular components were well fixed and pelvic discontinuity healed in all patients. Conclusion: Custom triflange PMI is an excellent option for management of complex and extensive acetabular defects with or without pelvic discontinuity.
Abstract
Purpose: Reconstruction of extensive acetabular bone defects is one of the most challenging problems encountered by arthroplasty surgeons. Triflange patient matched implants (PMI) offer the potential advantages of immediate, rigid fixation with a superior individualized fit. The purpose of this study was to evaluate the clinical and radiographic midterm results of PMI in extensive acetabular defect reconstruction. Materials and Methods: The current prospectively designed retrospective review examined 13 consecutive patients (5 males and 8 females) with a mean age of 69 years undergoing revision hip arthroplasty with Paprosky type 3B acetabular defects reconstructed using PMI between October 2011 and December 2016. A successful result was defined as a postoperative increase in Harris hip score (HHS) of >20 points with a radiographically stable implant (assessed with hip X-rays) and no need for additional acetabular reconstruction. Results: Twelve out of the 13 patients in the study were available for follow-up with mean duration of 50 months. One patient died during the study period due to an unrelated cause. The mean HHS increased from 41 to 82 points. Eleven out of 12 acetabular components were well fixed and pelvic discontinuity healed in all patients. Conclusion: Custom triflange PMI is an excellent option for management of complex and extensive acetabular defects with or without pelvic discontinuity.
참고문헌 (26)
- Paprosky W, "The treatment of pelvic discontinuity with acetabular cages", Clin Orthop Relat Res, 453, pp.183~187 (2006)
- Bozic KJ, "The epidemiology of revision total hip arthroplasty in the United States", J Bone Joint Surg Am, 91, pp.128~133 (2009)
- Kurtz S, "Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030", J Bone Joint Surg Am, 89, pp.780~785 (2007)
- Dearborn JT, "High placement of an acetabular component inserted without cement in a revision total hip arthroplasty : results after a mean of ten years", J Bone Joint Surg Am, 81, pp.469~480 (1999)
- Whaley AL, "Extra-large uncemented hemispherical acetabular components for revision total hip arthroplasty", J Bone Joint Surg Am, 83, pp.1352~1357 (2001)
- Ballester Alfaro JJ, "Trabecular Metal buttress augment and the Trabecular Metal cup-cage construct in revision hip arthroplasty for severe acetabular bone loss and pelvic discontinuity", Hip Int, 7, pp.S119~S127 (2010)
- Paprosky WG, "The treatment of acetabular bone defects with an associated pelvic discontinuity", Clin Orthop Relat Res, 441, pp.216~220 (2005)
- Emms NW, "Mid-to long-term results of irradiated allograft in acetabular reconstruction : a follow-up report", J Bone Joint Surg Br, 91, pp.1419~1423 (2009)
- Taunton MJ, "Pelvic discontinuity treated with custom triflange component : a reliable option", Clin Orthop Relat Res, 470, pp.428~434 (2012)
- Christie MJ, "Bridging massive acetabular defects with the triflange cup : 2-to 9-year results", Clin Orthop Relat Res, (393), pp.216~227 (2001)
- Harris WH, "Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation", J Bone Joint Surg Am, 51, pp.737~755 (1969)
- Paprosky WG, "Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation", J Arthroplasty, 9, pp.33~44 (1994)
- Little JP, "Consistency of ASA grading", Anaesthesia, 50, pp.658~659 (1995)
- Berasi CC 4th, "Are custom triflange acetabular components effective for reconstruction of catastrophic bone loss", Clin Orthop Relat Res, 473, pp.528~535 (2015)
- Massin P, "Evaluation of cementless acetabular component migration. An experimental study", J Arthroplasty, 4, pp.245~251 (1989)
- Sheth NP, "Acetabular bone loss in revision total hip arthroplasty : evaluation and management", J Am Acad Orthop Surg, 21, pp.128~139 (2013)
- Baauw M, "A custom-made acetabular implant for Paprosky type 3 defects", Orthopedics, 40, pp.e195~e198 (2017)
- Reid C, "Revision total hip arthroplasty : addressing acetabular bone loss", SA Orthop J, 11, pp.34~46 (2012)
- Sculco PK, "The evolution of the cup-cage technique for major acetabular defects : full and half cup-cage reconstruction", J Bone Joint Surg Am, 99, pp.1104~1110 (2017)
- Oommen AT, "Fate of bone grafting for acetabular defects in total hip replacement", Indian J Orthop, 49, pp.181~186 (2015)
- Berend ME, "The patient-specific Triflange acetabular implant for revision total hip arthroplasty in patients with severe acetabular defects : planning, implantation, and results", Bone Joint J, 100(1 Supple A), pp.50~54 (2018)
- DeBoer DK, "Revision total hip arthroplasty for pelvic discontinuity", J Bone Joint Surg Am, 89, pp.835~840 (2007)
- Colen S, "A modified custommade triflanged acetabular reconstruction ring(MCTARR)for revision hip arthroplasty with severe acetabular defects", Acta Orthop Belg, 79, pp.71~75 (2012)
- Van Kleunen JP, "Acetabular revisions using trabecular metal cups and augments", J Arthroplasty, 24(6 Suppl), pp.64~68 (2009)
- Kosashvili Y, "Acetabular revision using an anti-protrusion(ilio-ischial)cage and trabecular metal acetabular component for severe acetabular bone loss associated with pelvic discontinuity", J Bone Joint Surg Br, 91, pp.870~876 (2009)
- Goodman GP, "The custom triflange cup : build it and they will come", Bone Joint J, 98(1 Suppl A), pp.68~72 (2016)