BACKGROUND Acetabular bone loss is a challenging problem for revision hip surgeons. This study aimed to explore long-term outcomes of patients who have undergone cemented acetabular revision in conjunction with trabecular metal augmentation and impaction bone grafting in cases with significant segmental bone loss. METHODS All patients who underwent cemented acetabular revision requiring impaction bone grafting and trabecular metal augments with a minimum Paprosky score of 2B and minimum follow up of 5 years were identified. Pre- and postoperative WOMAC scores were compared. An assessment of pre- and postoperative hip centre of rotation was performed and compared to native centre of rotation. Immediate postoperative centre of rotation was then compared to radiographs at latest follow up to measure for migration of acetabular components. RESULTS 42 patients were identified. Mean age was 53 years old with 7 males and 35 female patients. Mean follow-up was 9.5 years. Preoperative WOMAC score was 30 and there was an increase to 90 (p < 0.01) at latest follow-up. No hips were revised for loosening or infection. There was a mean improvement in centre of rotation of 6.80 mm (CI, 4.57-9.03 mm) which was significant (p < 0.00002). There was no change of position of centre of rotation from immediate postoperative radiographs and those at latest follow up (p = 0.3). CONCLUSIONS Cemented acetabular components work well in conjunction with trabecular metal augments and impacted bone grafts in reconstructing complex acetabular defects. Together they provide immediate and long-term component stability, with excellent long-term clinical and radiological outcomes.

中文翻译：

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骨水泥髋臼组件与小梁金属增强物相结合，可以为严重的髋臼骨丢失提供良好的长期生存率。

背景技术髋臼骨丢失对于髋关节翻修外科医生来说是一个具有挑战性的问题。本研究旨在探讨在严重节段性骨丢失的情况下接受骨水泥髋臼翻修结合小梁金属增强和打压骨移植的患者的长期结果。方法 确定所有接受骨水泥髋臼翻修术、需要打压骨移植和小梁金属增强的患者，帕普罗斯基评分最低为 2B，随访时间最短为 5 年。比较术前和术后的 WOMAC 评分。对术前和术后髋关节旋转中心进行评估，并与自然旋转中心进行比较。然后将术后即刻的旋转中心与最近一次随访时的X光照片进行比较，以测量髋臼假体的迁移情况。结果 确定了 42 名患者。平均年龄为 53 岁，其中男性 7 例，女性 35 例。平均随访时间为 9.5 年。术前 WOMAC 评分为 30，最近一次随访时升至 90（p < 0.01）。没有因髋部松动或感染而进行修复。旋转中心平均改善 6.80 毫米（CI，4.57-9.03 毫米），非常显着 (p < 0.00002)。从术后即刻和最后一次随访的 X 光照片来看，旋转中心的位置没有变化 (p = 0.3)。结论 在重建复杂的髋臼缺损时，骨水泥髋臼组件与小梁金属增强体和阻生骨移植物相结合效果良好。它们共同提供了即时和长期的组件稳定性，并具有出色的长期临床和放射学结果。