Clinical Therapeutic Effect of Total Hip Arthroplasty with Cementless Cup on Acetabular Protrusion_West China Medical Journal

Authors：

YU Yang , FAN Haiquan , CHEN Ming , HUANG Hongjie

Department of Spinal Surgery, Chengdu 416 Hospital, Chengdu, Sichuan 610051, P. R. China;

Corresponding author：

Keywords：

髋臼内陷; 全髋关节置换; 生物型假体

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目的　探讨使用生物型非骨水泥假体治疗髋臼内陷症的近期疗效。方法　 2007年6月－2010年5月，对11例12髋髋臼内陷患者行生物型假体全髋关节置换术。男2例，女9例；年龄38～57岁，平均47.3岁。其中继发于类风湿性关节炎7例，创伤4例；病程1～18年，平均8.9年；轻度髋臼内陷6髋，中度髋臼内陷6髋。采用Harris评分标准进行临床疗效评估，摄X线片进行影像学评估。结果　术后第2天X线片示，人工股骨头距Kohler’s线外移（1.42 ± 2.27）mm，较术前股骨头内陷（?5.17 ± 2.04）mm明显改善（P＜0.05）。术后1周，患者Harris评分为（85.75 ± 4.73）分，较术前（39.75 ± 5.24）分显著提高（P＜0.05）。术后1年X线片示髋臼假体与髋臼内侧壁无透亮线，已骨融合。术后患者获随访2～5年。髋臼假体均无松动移位、脱位或移植骨的吸收。结论　使用生物型非骨水泥假体结合自体骨移植治疗髋臼内陷症，能有效恢复髋臼运动中心的解剖位置，近期临床疗效满意。

Citation： YU Yang,FAN Haiquan,CHEN Ming,HUANG Hongjie. Clinical Therapeutic Effect of Total Hip Arthroplasty with Cementless Cup on Acetabular Protrusion. West China Medical Journal, 2012, 27(8): 1150-1152. doi: Copy

1.	Sotelo-Garza A, Charnley J. The results of Charnley arthroplasty of hip performed for protrusio acetabuli [J]. Clin Orthop Relat Res, 1978, (132): 12-18.
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3.	Dunlop CC, Jones CW, Maffulli N. Protrusio acetabuli[J]. Bull Hosp Jt Dis, 2005, 62(3-4): 105-114.
4.	Garcia-Cimbrelo E, Diaz-Martin A, Madero R, et al. Loosening of the cup after low-friction arthroplasty in patients with acetabular protrusion. The importance of the position of the cup [J]. J Bone Joint Surg Br, 2000, 82(1): 108-115.
5.	Welten ML, Schreurs BW, Buma P, et al. Acetabular reconstruction with impacted morcellized cancellous bone autograft and cemented primary total hip arthroplasty: a 10- to 17-year follow-up study [J]. J Arthroplasty, 2000, 15(7): 819-824.
6.	Mullaji AB, Marawar SV.Primary total hip arthroplasty in protrusio acetabuli using impacted morsellized bone grafting and cementless cups: a medium-term radiographic review[J]. J Arthroplasty, 2007, 22(8): 1143-1149.
7.	马金忠, 朱力波, 桑伟林.全髋关节置换术治疗髋臼内陷症[J].中国矫形外科杂志, 2008, 16(15): 1136-1137.
8.	Bourne RB, Corten K.Cemented versus cementless stems: a verdict is in[J]. Orthopedics, 2010, 33(9): 638.
9.	D′ Antonio JA, Capello WN, Borden LS, et al. Classification and management of acetabular abnormalities in total hip arthroplasty[J]. Clin Orthop Relat Res, 1989, (243): 126-137.
10.	仉建国, 翁习生, 邱贵兴.人工髋关节翻修术中对髋臼骨缺损的处理[J]. 中华骨科杂志, 2000, 20(4): 252-253.
11.	Garbuz D, Morsi E, Mohamed N, et al. Classification and reconstruction in revision acetabular arthroplasty with bone stock deficiency[J]. Clin Orthop Relat Res, 1996, (324): 98-107.
12.	Clark CR, Huddleston HD, Schoch EP 3rd et al. Leg-length discrepancy after total hip arthroplasty[J]. J Am Acad orthop Surg, 2006, 14(1): 38-45.
13.	Terry MA, Winell JJ, Green DW, et al. Measurement variance in limb length discrepancy: clinical and radiographic assessment of interobserver and intraobserver variability[J]. J Pediatr Orthop, 2005, 25(2): 197-201.

1. 　Sotelo-Garza A, Charnley J. The results of Charnley arthroplasty of hip performed for protrusio acetabuli [J]. Clin Orthop Relat Res, 1978, (132): 12-18.
2. 　Harris WH.Traumatic arthritis of the hip after dislocation and acetabular fractures：treatment by mold arthroplasty. An end-result study using a new method of result evaluation[J]. J Bone Joint Surg Am, 1969, 51(4): 737-755.
3. 　Dunlop CC, Jones CW, Maffulli N. Protrusio acetabuli[J]. Bull Hosp Jt Dis, 2005, 62(3-4): 105-114.
4. 　Garcia-Cimbrelo E, Diaz-Martin A, Madero R, et al. Loosening of the cup after low-friction arthroplasty in patients with acetabular protrusion. The importance of the position of the cup [J]. J Bone Joint Surg Br, 2000, 82(1): 108-115.
5. 　Welten ML, Schreurs BW, Buma P, et al. Acetabular reconstruction with impacted morcellized cancellous bone autograft and cemented primary total hip arthroplasty: a 10- to 17-year follow-up study [J]. J Arthroplasty, 2000, 15(7): 819-824.
6. 　Mullaji AB, Marawar SV.Primary total hip arthroplasty in protrusio acetabuli using impacted morsellized bone grafting and cementless cups: a medium-term radiographic review[J]. J Arthroplasty, 2007, 22(8): 1143-1149.
7. 　马金忠, 朱力波, 桑伟林.全髋关节置换术治疗髋臼内陷症[J].中国矫形外科杂志, 2008, 16(15): 1136-1137.
8. 　Bourne RB, Corten K.Cemented versus cementless stems: a verdict is in[J]. Orthopedics, 2010, 33(9): 638.
9. 　D′ Antonio JA, Capello WN, Borden LS, et al. Classification and management of acetabular abnormalities in total hip arthroplasty[J]. Clin Orthop Relat Res, 1989, (243): 126-137.
10. 　仉建国, 翁习生, 邱贵兴.人工髋关节翻修术中对髋臼骨缺损的处理[J]. 中华骨科杂志, 2000, 20(4): 252-253.
11. 　Garbuz D, Morsi E, Mohamed N, et al. Classification and reconstruction in revision acetabular arthroplasty with bone stock deficiency[J]. Clin Orthop Relat Res, 1996, (324): 98-107.
12. 　Clark CR, Huddleston HD, Schoch EP 3rd et al. Leg-length discrepancy after total hip arthroplasty[J]. J Am Acad orthop Surg, 2006, 14(1): 38-45.
13. 　Terry MA, Winell JJ, Green DW, et al. Measurement variance in limb length discrepancy: clinical and radiographic assessment of interobserver and intraobserver variability[J]. J Pediatr Orthop, 2005, 25(2): 197-201.

West China Medical Journal

Clinical Therapeutic Effect of Total Hip Arthroplasty with Cementless Cup on Acetabular Protrusion

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