An Early Report of the Use of a Modular Dual Mobility Articulation in Revision Acetabular Reconstruction
An Early Report of the Use of a Modular Dual Mobility Articulation in Revision Acetabular Reconstruction
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DOI：
10.1016/j.arth.2018.05.005
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发表时间：
2018-09-01
影响因子：
3.5
通讯作者：
Masri, Bassam S.
中科院分区：
文献类型：
--
作者：
Diamond, Owen J.;Konan, Sujith;Masri, Bassam S.
背景：不稳定仍然是髋关节翻修手术后的主要问题之一。本研究的目的是回顾使用模块化双活动关节进行髋臼翻修重建的临床、放射学和患者报告的结果，并通过测量血清微量金属离子水平调查微动腐蚀的风险。方法：确定了在髋关节翻修手术时插入模块化双活动（Stryker，Mahwah，新泽西）杯后进行至少 24 个月随访的 60 名连续患者。随访包括临床和放射学患者审查以及功能结果测量，并对一部分患者的金属离子（钴和铬）水平进行了检查。结果：在最近的随访中，5 名患者死亡，3 名患者因持续不稳定而进行了翻修手术，3 名患者因感染而接受了翻修手术。总体功能结果（西安大略大学和麦克马斯特大学骨关节炎指数平均为 76，加州大学洛杉矶分校为 5.6，牛津大学平均为 74.7，Short Form-12 体力 41.6/心理 53.3）和总体疼痛缓解（西安大略和麦克马斯特大学骨关节炎指数平均疼痛评分 78.3）得分良好。平均满意度评分为 78 分（满分 100 分）。最近一次随访时血清微量金属铬和钴的中位水平分别为 0.4 mg/L（范围 0.1-6.1 mg/L）和 0.42 mg/L（范围 0.21-9.42 μg/L）。以翻修为终点的生存率为 90%。结论：对于不稳定风险高的进行髋关节翻修手术的患者来说，具有模块化功能的双活动杯是一个极好的选择。该系列提供了良好的患者报告结果测量以及较低的并发症和翻修率。 (C) 2018 Elsevier Inc. 保留所有权利。
Background: Instability remains one of the main problems after revision hip surgery. The aim of this study was to review the clinical, radiological, and patient-reported outcomes with the use of modular dual-mobility articulation for revision acetabular reconstruction and investigate the risk of fretting corrosion by measuring serum trace metal ion levels.Methods: Sixty consecutive patients with a minimum of 24-month follow-up after the insertion of a modular dual-mobility (Stryker, Mahwah, NJ) cup at the time of revision hip surgery were identified. Follow-up included clinical and radiological patient review and functional outcome measures, and a subset of patients had their metal ion (cobalt and chromium) levels checked.Results: At the most recent follow-up, 5 patients had died, 3 patients have been revised because of ongoing instability, and 3 patients have had revision surgery due to infection. Overall functional outcome (mean Western Ontario and McMaster Universities Osteoarthritis Indexfunction 76, University of California, Los Angeles 5.6, mean Oxford 74.7, Short Form-12 physical 41.6/mental 53.3) and overall pain relief (mean Western Ontario and McMaster Universities Osteoarthritis Index pain score 78.3) scores were good. The mean satisfaction score was 78 of 100. The median serum trace metal chromium and cobalt levels at the most recent follow-up were 0.4 mg/L (range 0.1-6.1 mg/L) and 0.42 mg/L (range 0.21-9.42 mu g/L), respectively. The survival with revision as the end point was 90%.Conclusions: Dual-mobility cups with modularity represent an excellent option for the patient having revision hip surgery at high risk of instability. This series presents good patient-reported outcome measures and a low complication and revision rate. (C) 2018 Elsevier Inc. All rights reserved.