PDF(Pubmed)
Abstract：
Background Dislocation is one of the most prominent and challenging complications following the revision of total hip arthroplasty (THA). Dual-mobility cups are an option to address this problem. There is, however, little data on the outcomes of modern modular dual-mobility (MDM) cups in the revision of THA. In this study, the clinical and radiological outcomes following the revision of THA with an MDM cup using the direct anterior approach (DAA) were evaluated. Methodology We retrospectively reviewed patients who underwent a revision of THA between March 2017 and July 2019. The inclusion criteria were a revision of THA using an MDM cup through the DAA. A uniform acetabular implant was used in each revision. Outcome measures were assessed radiographically and clinically. The clinical outcome measures consisted of dislocation, infection, and re-revision. Functional assessment was performed using the Harris Hip Score preoperatively and at the last clinical examination in our department. Results This study retrospectively identified a cohort of 26 patients who underwent a revision of THA. Two patients were excluded due to incomplete follow-up because they died. Finally, 24 patients were included. A total of 17 isolated acetabular revisions and seven complete revisions were performed with a mean follow-up of 39 months (range = 29-59). No dislocations or deep infections were observed in our population to date. Except for one case of early aseptic loosening of the acetabular component, we observed no other signs of loosening, osteolysis, migration, or intraprosthetic dislocation. Conclusions THA revision through the DAA using an MDM cup is a safe and effective procedure. We observed no dislocation in a high-risk population undergoing THA revision surgery during a minimal follow-up of two years.
摘要：
背景脱位是全髋关节置换术（THA）翻修后最突出和最具挑战性的并发症之一。双移动杯是解决这个问题的一种选择。有,然而,关于THA修订版中现代模块化双移动性(MDM)杯的结果的数据很少。在这项研究中,我们评估了使用直接前入路(DAA)用MDM杯翻修THA后的临床和放射学结果.方法我们回顾性分析了2017年3月至2019年7月期间接受THA翻修的患者。纳入标准是使用MDM杯通过DAA修订THA。在每次翻修中使用均匀的髋臼植入物。结果测量进行了影像学和临床评估。临床结果指标包括脱位，感染,重新修订。术前和我科最后一次临床检查时使用Harris髋关节评分进行功能评估。结果本研究回顾性分析了26例接受THA翻修的患者。两名患者因死亡随访不完整而被排除在外。最后,包括24名患者。总共进行了17次孤立的髋臼修订和7次完整修订，平均随访39个月（范围=29-59）。迄今为止，在我们的人群中未观察到脱位或深部感染。除1例髋臼组件早期无菌性松动外，我们没有观察到其他松动的迹象，骨质溶解,迁移,或假体内脱位。结论使用MDM杯通过DAA进行THA翻修是一种安全有效的手术。在两年的最小随访中，我们观察到接受THA翻修手术的高危人群没有脱位。
