“双杯”技术治疗Paprosky Ⅲ型髋臼缺损的疗效分析

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Abstract Objective To evaluate the early clinical outcomes of the “Double Cup” technique (titanium ring-free tantalum metal revision cup as an augmentation block) for the treatment of Paprosky Type Ⅲ acetabular defects.Methods A retrospective analysis was conducted to evaluate the early clinical outcomes of 54 revision cases treated with the “Double Cup” technique for Paprosky Type Ⅲ acetabular defects at the First Affiliated Hospital of University of Science and Technology of China.from 2017 to 2023.The cohort consisted of 27 male and 27 female patients，with ages ranging from 30 to 92 years [mean age (65.8±12.3)years].Clinical functional outcomes were assessed by recording preoperative and final follow-up Harris hip scores (HHS)，Oxford hip scores (OHS)，and 36-item short form survey (SF-36) functional scores.Preoperative and postoperative position of the center of rotation (COR) of the hip joint and leg length discrepancy (LLD) were evaluated radiographically.The occurrence of postoperative complications such as prosthesis loosening was also assessed during follow-up.Results All 54 patients were followed up for an average duration of (35.3±20.9)months，ranging from 8 to 80 months.Preoperatively，their HHS，OHS，and SF-36 functional scores were (35.6±10.5)，(24.4±7.1)，and (805.7±47.5) points，respectively.At the final follow-up，these scores improved significantly to (90.6±11.5)，(44.0±4.2)，and (859.4±47.4) points，respectively (P＜0.001)，indicating a marked improvement in hip function and overall health status.Radiographic examinations during the final follow-up revealed substantial improvements in acetabular COR and LLD compared to preoperative values (P＜0.001)，suggesting successful biomechanical reconstruction.No cases of periprosthetic infection were observed postoperatively.However，6 patients experienced prosthesis dislocation，of which only 1 patient required re-revision surgery due to recurrent dislocation during the follow-up period.Conclusion The “Double Cup” technique indeed represents a viable and reliable surgical option for the reconstruction of severe acetabular defects classified as Paprosky Type Ⅲ A and Ⅲ B.This technique has demonstrated low complication rates，high safety standards，and promising functional outcomes for patients.Therefore，it is indeed worthy of being actively promoted and considered in clinical practice for patients with these complex acetabular defects.The technique’s ability to effectively restore acetabular anatomy and biomechanics contributes significantly to its success and patient satisfaction.

Key words： total hip revision surgery acetabular defect “Double Cup&rdquo technique modular reconstruction tantalum block

Corresponding Authors: Zhu Chen

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	Liu Quan
	Zhang Rongwei
	Mei Jiawei
	Zhu Wanbo
	Ma Ruixiang
	Zhang Xianzuo
	Zhu Chen

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Liu Quan,Zhang Rongwei,Mei Jiawei, et al. “Double Cup” Technique：A Reliable Solution for the Treatment of Paprosky Type Ⅲ Acetabular Defects[J]. sygkzz, 2024, 30(5): 404-.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2024/V30/I5/404

［1］Hipfl C，Janz V，Lchel J，et al.Cup-cage reconstruction for severe acetabular bone loss and pelvic discontinuity［J］.Bone Joint J，2018，100-B(11)：1442-1448.
［2］Fryhofer GW，Ramesh S，Sheth NP.Acetabular reconstruction in revision total hip arthroplasty［J］.J Clin Orthop Trauma，2020，11(1)：22-28.
［3］宋伟，张育民，姚建锋，等.人工髋关节初次置换术后失败翻修策略分析［J］.实用骨科杂志，2016，22(1)：10-13.
［4］Winther SS，Petersen M，Yilmaz M，et al.Custom-made triflanged implants in reconstruction of severe acetabular bone loss with pelvic discontinuity after total hip arthroplasty consecutive cohort study：two to 11 years of follow-up［J］.Bone Jt Open，2022，3(11)：867-876.
［5］Li H，Tan KG，Li Z，et al.Impaction bone grafting with low dose irradiated freeze-dried allograft bone for acetabular reconstruction［J］.Orthop Surg，2022，14(10)：2519-2526.
［6］吴浩波，朱晗晓，严世贵，等.Jumbo臼杯在全髋关节翻修术髋臼骨缺损重建中的应用［J］.中华骨科杂志，2016，36(23)：1471-1478.
［7］Malahias MA，Ma QL，Gu A，et al.Outcomes of acetabular reconstructions for the management of chronic pelvic discontinuity：A systematic review［J］.J Arthroplasty，2020，35(4)：1145-1153.
［8］Mancino F，Cacciola G，Di Matteo V，et al.Reconstruction options and outcomes for acetabular bone loss in revision hip arthroplasty［J］.Orthop Rev (Pavia)，2020，12(Suppl 1)：8655.
［9］Alqwbani M，Wang Z，Wang Q，et al.Porous tantalum shell and augment for acetabular defect reconstruction in revision total hip arthroplasty：A mid-term follow-up study［J］.Int Orthop，2022，46(7)：1515-1520.
［10］马涛，郝林杰，张育民，等.金属钛网联合打压植骨治疗严重髋臼内壁骨缺损1例报告［J］.实用骨科杂志，2020，26(4)：381-384.
［11］Somers JF，Timperley AJ，Norton M，et al.Block allografts in revision total hip arthroplasty［J］.J Arthroplasty，2002，17(5)：562-568.
［12］Sayac G，Neri T，Schneider L，et al.Low revision rates at more than 10 years for dual-mobility cups cemented into cages in complex revision total hip arthroplasty［J］.J Arthroplasty，2020，35(2)：513-519.
［13］Brooker AF，Bowerman JW，Robinson RA，et al.Ectopic ossification following total hip replacement.Incidence and a method of classification［J］.J Bone Joint Surg (Am)，1973，55(8)：1629-1632.
［14］Migaud H，Common H，Girard J，et al.Acetabular reconstruction using porous metallic material in complex revision total hip arthroplasty：A systematic review［J］.Orthop Traumatol Surg Res，2019，105(1S)：S53-S61.
［15］林天烨，张庆文，何伟，等.同种异体骨颗粒填塞植骨联合Jumbo臼杯在中重度髋臼骨缺损髋关节翻修中的应用［J］.中国骨与关节杂志，2019，8(6)：459-464.
［16］Yoshino K，Tsukeoka T，Tsuneizumi Y，et al.Revision total hip arthroplasty using a cementless cup supporter and iliac autograft：A minimum of 15-year follow-up［J］.J Arthroplasty，2017，32(11)：3495-3501.
［17］曹国定，裴豫琦，李旭升，等.髋关节翻修中髋臼骨缺损的处理现状及3D打印的应用［J］.实用骨科杂志，2020，26(9)：811-815.
［18］郭宇，王凌，丁育健，等.3D打印钛合金骨小梁金属臼杯联合植骨重建髋臼骨缺损的早期疗效［J］.实用骨科杂志，2020，26(6)：491-494.
［19］Webb JE，McGill RJ，Palumbo BT，et al.The double-cup construct：A novel treatment strategy for the management of paprosky ⅢA and ⅢB acetabular defects［J］.J Arthroplasty，2017，32(9S)：S225-S231.