Research progress in Cup-cage reconstruction for patients with chronic pelvic discontinuity after total hip arthroplasty
濮兴孝 1王秋入 1李乾浩 1蔡李俊 1韩广弢 1康鹏德1
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作者信息
1. 四川大学华西医院骨科(成都 610041)
折叠
摘要
目的 总结人工全髋关节置换术(total hip arthroplasty,THA)患者翻修中应用Cup-cage重建技术重建慢性骨盆不连续(chronic pelvic discontinuity,CPD)的研究进展.方法 查阅近年国内外相关文献,针对THA翻修患者应用Cup-cage重建技术重建CPD的术前评估、术中操作要点、临床及影像学疗效评价、手术局限性及术后并发症进行总结.结果 对于CPD的治疗,Cup-cage重建技术通过使用髋臼加强环术中恢复骨盆连续性、术后早期提供稳定性,实现了术后远期髋臼杯骨长入、CPD愈合及假体生物固定.术前需对手术部位及患者全身情况进行评估;术中需重建骨盆连续性、恢复髋关节旋转中心及避免神经、血管损伤.目前研究表明Cup-cage 重建术后患者临床及影像学疗效显著,并获得可接受的假体生存率.然而,针对CPD的特定分型标准有待完善、对Cup-cage重建最佳手术入路及内固定方式缺乏证据,术后影响假体生存率的因素仍未明确.结论 Cup-cage重建技术可有效治疗THA术后CPD,但仍需要探索CPD分型、手术入路、内固定方式及影响假体生存率的因素.
Abstract
Objective To summarize research progress on application of Cup-cage reconstruction in revision of chronic pelvic discontinuity(CPD)in patients undergoing total hip arthroplasty(THA).Methods Relevant literature at home and abroad in recent years was reviewed to summarize the principles of the Cup-cage reconstruction,preoperative patient assessment,intraoperative skills,clinical and radiological effectiveness,limitations,and postoperative complications.Results For the treatment of CPD,the Cup-cage reconstruction achieved long-term acetabular cup bone ingrowth,CPD healing,and biologic fixation of the prosthesis by restoring pelvic continuity.Preoperative evaluation of the surgical site and general condition is necessary.The main intraoperative objectives are to reconstruct pelvic continuity,restore the center of rotation of the hip,and avoid neurovascular injury.Current studies have demonstrated significant clinical and radiological effectiveness as well as acceptable prosthesis survival rates after operation.Nevertheless,there is a lack of evidence regarding the staging of CPD,the optimal surgical approach and internal fixation,and the factors influencing postoperative prosthesis survival remain undefined.Conclusion Cup-cage reconstruction can be an effective treatment for CPD after THA,but there is still a need to explore CPD staging,Cup-cage approach and internal fixation,and influencing factors on prosthesis survival.
关键词
Cup-cage重建技术/人工全髋关节置换术/慢性骨盆不连续
Key words
Cup-cage renconstruction/total hip arthroplasty/chronic pelvic discontinuity
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