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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骨水泥髋臼部件与小梁金属增强物相结合，为严重的髋臼骨丢失提供了极好的长期存活率

背景：

髋臼骨丢失对于翻修髋外科医生来说是一个具有挑战性的问题。本研究旨在探讨骨水泥髋臼翻修联合小梁金属增强和嵌塞骨移植患者在明显节段性骨丢失的情况下的长期结果。

方法：

确定了所有接受骨水泥髋臼翻修需要撞击骨移植和小梁金属增强术且最低 Paprosky 评分为 2B 且最短随访时间为 5 年的患者。比较术前和术后 WOMAC 评分。对术前和术后髋关节旋转中心进行了评估，并与自然旋转中心进行了比较。然后将术后即刻旋转中心与最近随访时的 X 光片进行比较，以测量髋臼组件的迁移。

结果：

确定了 42 名患者。平均年龄 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 ，最近随访时增加到 90（p < 0.01）。没有因松动或感染而对髋部进行翻修。旋转中心平均改善了 6.80 毫米（CI，4.57-9.03 毫米），这是显着的（p  < 0.00002）。从术后即刻的 X 光片和最近随访的那些（p  = 0.3）来看，旋转中心的位置没有变化。

结论：

骨水泥髋臼部件与小梁金属增强物和受阻骨移植物在重建复杂的髋臼缺损时效果很好。它们共同提供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。