基于骨水泥多孔双动髋臼杯多角度螺钉固定的老年体弱髋臼骨折患者全髋关节置换术 (2023)

基于骨水泥多孔双动髋臼杯多角度螺钉固定的老年体弱髋臼骨折患者全髋关节置换术 (2023)Total Hip Arthroplasty with Cemented Dual Mobility Cup into a Fully Porous Multihole Cup with Variable Angle Locking Screws for Acetabular Fractures in the Frail Elderly

van den Broek M, Govaers K. Total Hip Arthroplasty with Cemented Dual Mobility Cup into a Fully Porous Multihole Cup with Variable Angle Locking Screws for Acetabular Fractures in the Frail Elderly

转载文章的原链接1：

https://pubmed.ncbi.nlm.nih.gov/36937212/

转载文章的原链接2：

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10020729/

Abstract

Purpose: The purpose was to examine the clinical and radiological outcomes after surgical treatment of acetabular fractures with total hip arthroplasty with a dual mobility cup cemented into a porous multihole cup in the population of frail elderly patients.

Materials and methods: A retrospective review of 16 patients who underwent surgery (mean age, 76.7 years) with a mean follow-up period of 36.9 months was conducted. Following surgery, patients underwent postoperative follow-up at six weeks, three, six, and 12 months and clinical and radiological examinations were performed.

Results: Classification of fractures was based on the Letournel classification. Following surgery, all patients were allowed weight-bearing as tolerated immediately postoperative. Fourteen patients showed maintenance of preoperative mobility status at one year. The mean Harris hip score was 64.8 (range, 34.7-82.8) and 80.0 (range, 60.8-93.8) at three months and one year, respectively. The mortality rate was 12.5% at one year (2/16). Complications included heterotopic ossification (2/16), deep venous thrombosis (1/16), heamatoma (1/16), and femoral revision due to a Vancouver B2 fracture (1/16). No case of deep infection, dislocation, or implant loosening was reported.

Conclusion: Total hip arthroplasty using a dual mobility cup cemented into a porous multihole cup with locking screws resulted in a stable construct with a capacity for immediate weight-bearing as tolerated with rapid relief of pain. The findings of this study suggest that this procedure can be regarded as a safe method that has shown promising clinical and radiological outcomes for treatment of patients with medical frailty.

Keywords: Acetabulum; Arthroplasty; Fractures; Frailty.

Fig.1. [A]Preoperative anteroposterior radiograph of the right pelvis shows a pure transverse acetabular fracture. [B] Postoperative radiograph shows the dual mobility cup cemented into a multihole cup fixed with multiple angle locking screws into ilium, ischium, and pubis.

Fig.2. Introduction of the multihole, fully porous acetabular cup into the acetabulum.

Fig. 3. Cementing of a dual mobility cup into the multihole cup in the precise version and inclination.

CONCLUSION

In conclusion, the use of a DM cup cemented into a porous multihole cup with locking screws appears to be a safe option for treatment of acetabular fractures in elderly patients with encouraging functional and radiological outcomes.