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首页> 外文期刊>Open Journal of Urology >Treatment of Bilateral Recurrent Dislocation of Hip Pros-thesis with Malpositioned Well-Fixed Shell: A Case Report
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Treatment of Bilateral Recurrent Dislocation of Hip Pros-thesis with Malpositioned Well-Fixed Shell: A Case Report

机译：位置不固定的固定壳治疗髋关节假体双侧复发性脱位：病例报告

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摘要

Dislocations of total hip prostheses cause pain and patient dissatisfaction. Recurrent dislocations are difficult to treat mainly when the acetabular metal shell is well-fixed. The purpose of this article was to describe the surgical technique used for the treatment of a bilateral recurrent posterior dislocation after a cementless total hip prosthesis, caused by excessive inclination of acetabular components, in a 72-year-old patient. On both sides, acetabular metal shell, porouscoated, was well-fixed. Revision of the entire acetabular component could be an appropriate therapeutic option because it was malpositioned. Nevertheless, a conservative operation was performed. The metal shell was left in situ and the preexisting polyethylene liner was removed and replaced by a new undersized cross-linked polyethylene liner, then, cemented into the shell and properly oriented. An acetabular cemented augmentation reinforced by 3 cortical screws was associated with the reconstruction. This report suggests that cementation of new liner into a malpositioned well- fixed metal shell associated with an acetabular cemented augmentation is a simple and safe technique for the management of recurrent hip dislocation, for elderly patients in which it is advisable to avoid a major revision hip surgery by medical comorbidities. Nonetheless, further studies with medium-and long-term follow-up are needed to validate this technique.
机译：全髋关节假体脱位会引起疼痛和患者不满。复发性脱位主要在髋臼金属壳固定好后很难治疗。本文的目的是描述用于治疗72岁患者髋臼假体过度倾斜引起的非骨水泥型全髋关节置换术后双侧复发性后脱位的手术技术。在两侧，多孔涂层的髋臼金属壳固定良好。修改整个髋臼组件可能是合适的治疗选择，因为它位置不正确。尽管如此，还是进行了保守手术。将金属壳留在原处，并移除先前存在的聚乙烯衬里，并用新的尺寸较小的交联聚乙烯衬里代替，然后将其胶合到壳中并正确定向。由3个皮质螺钉加固的髋臼骨水泥骨增强与重建相关联。该报告表明，对于老年患者，将新衬管与髋臼骨水泥隆起相关的金属衬垫牢固固定在位置不正确的金属壳中是一种简单安全的技术，可避免复发性髋关节脱位由医疗合并症手术。尽管如此，仍需要对中长期随访进行进一步研究以验证该技术。

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