目标:在残留脊髓灰质炎相关损伤的患者中,全髋关节置换术(THA)是具有挑战性的,由于高频率的危险因素,如髋关节发育不良,位错,肌肉无力,和骨折。这项研究的目的是评估陶瓷陶瓷前入路THA的长期功能和影像学结果,双重移动性,或限制植入脊髓灰质炎后遗症患者。
目的:THA通过陶瓷陶瓷前路,双重移动性,或限制性植入是一种可靠的技术,不会导致不稳定或无菌性松动的过度风险。
方法:这项单中心回顾性研究包括1998年1月至2019年9月通过前路接受THA的连续脊髓灰质炎后遗症患者,植入陶瓷陶瓷,双重移动性,或受约束的植入物。哈里斯髋关节评分(HHS)植入物位置,和并发症(例如,感染和松动)是在最近一次面对面访问中收集的。
结果:该研究包括19名患者(23髋)。平均随访时间为5.2±4.2年(范围,2.0-10.6年)。23例手术中只有6例发生在肌肉无力的一侧。末次随访时平均HHS为80.4±10.4。一次手术(1/23,4%)后出现并发症,包括植入双活动杯2年后的假体内脱位。在最后的随访中,HHS与腰大肌和臀肌肌力无关(分别为rs=0.35,p=0.11和rs=0.37,p=0.09),并且在较弱与更强的一面(82.7±8.0vs.分别为79.5±11.3;p=0.53)。杯子位置更水平,从而优化功能,当程序在较弱的vs.更强的一侧(39.9°±4.3vs.分别为45.0°±6.8;p=0.02)。
结论:THA是改善脊髓灰质炎后遗症患者功能的良好选择。THA通过前路用陶瓷陶瓷,双重移动性,或限制性植入物是一种可靠的方法,不会有过度的不稳定或松动风险。
方法:IV.
OBJECTIVE: In patients with residual
poliomyelitis-related impairments, total hip arthroplasty (THA) is challenging due to the high frequency of risk factors such as hip dysplasia, dislocation, muscle weakness, and fracture. The objective of this study was to assess the long-term functional and radiographic outcomes of anterior-approach THA with a ceramic-ceramic, dual-mobility, or constrained implant in patients with
poliomyelitis sequelae.
OBJECTIVE: THA via the anterior approach with a ceramic-ceramic, dual-mobility, or constrained implant is a reliable technique that is not associated with excess risks of instability or aseptic loosening.
METHODS: This single-centre retrospective study included consecutive patients with
poliomyelitis sequelae who underwent THA between January 1998 and September 2019 via the anterior approach, with implantation of a ceramic-ceramic, dual-mobility, or constrained implant. The Harris Hip Score (HHS), implant position, and complications (e.g., infection and loosening) were collected during the most recent in-person visit.
RESULTS: The study included 19 patients (23 hips). Mean follow-up was 5.2 ± 4.2 years (range, 2.0-10.6 years). Only six of the 23 procedures were done on the side with greater muscle weakness. The mean HHS at last follow-up was 80.4 ± 10.4. A single procedure (1/23, 4%) was followed by a complication, consisting in intra-prosthetic dislocation 2 years after implantation of a dual-mobility cup. At last follow-up, the HHS was not associated with psoas and gluteus muscle strength (rs = 0.35, p = 0.11 and rs = 0.37, p = 0.09, respectively) and was not significantly different between the weaker vs. stronger side (82.7 ± 8.0 vs. 79.5 ± 11.3, respectively; p = 0.53). Cup position was more horizontal, thereby optimising function, when the procedure was done on the weaker vs. the stronger side (39.9° ± 4.3 vs. 45.0° ± 6.8, respectively; p = 0.02).
CONCLUSIONS: THA is a good option for improving function in patients with
poliomyelitis sequelae. THA via the anterior approach with a ceramic-ceramic, dual-mobility, or constrained implant is a reliable method that is not associated with an excess risk of instability or loosening.
METHODS: IV.