Introduction:

Acetabular reconstruction is a challenging problem in orthopaedic oncology, especially in extended defects (Paprosky Type 3A and Type 3B). In revision total hip arthroplasty (THA), 1 option is trabecular metal (TM) augments with a porous metal acetabular component. This study evaluated the use of TM augments in periacetabular malignant bone disease.

Methods:

15 patients were identified from our institutional database from 2000 to 2020 with either Paprosky Type 3A or Type 3B acetabular bone loss due to periacetabular malignancies that underwent at least 1 complex THA reconstruction with TM augments. Postoperative complications were documented, and clinical and radiographic outcomes were analysed. Radiological loosening or revision of the acetabular component were defined as endpoints.

Results:

There were 7 primary and 8 metastatic cancer patients. 5 were Type 3A and 10 were Type 3B defects after tumour resection. The average follow-up time was 23.8 (range 1.5–47) months. 1 patient required revision for acetabular component loosening after 7 months from the initial implantation. An additional 4 patients required surgical intervention for infection, they had stable TM augments at latest follow-up.

Conclusion:

TM augments with a porous metal acetabular component may be an alternative to the traditional cemented constructs.

中文翻译：

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小梁金属可增强严重恶性肿瘤相关髋臼骨丢失

介绍：

髋臼重建是骨科肿瘤学中的一个具有挑战性的问题，特别是在扩展缺损（Paprosky 3A 型和 3B 型）中。在翻修全髋关节置换术 (THA) 中，一种选择是用多孔金属髋臼组件增强小梁金属 (TM)。本研究评估了 TM 增强技术在髋臼周围恶性骨疾病中的应用。

方法：

从 2000 年至 2020 年，我们的机构数据库中确定了 15 名因髋臼周围恶性肿瘤导致 Paprosky 3A 型或 3B 型髋臼骨丢失的患者，这些患者至少接受了 1 次采用 TM 增强的复杂 THA 重建。记录术后并发症，并分析临床和放射学结果。髋臼假体的放射学松动或翻修被定义为终点。

结果：

有7名原发性癌症患者和8名转移性癌症患者。肿瘤切除后，5 例为 3A 型缺陷，10 例为 3B 型缺陷。平均随访时间为 23.8（范围 1.5-47）个月。1 名患者在初次植入 7 个月后因髋臼假体松动而需要翻修。另外 4 名患者因感染需要手术干预，他们在最近的随访中 TM 增强效果稳定。

结论：

带有多孔金属髋臼组件的 TM 增强体可能是传统骨水泥结构的替代方案。