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首页> 外文期刊>Journal of Clinical Medicine >Revision Arthroplasty Through the Direct Anterior Approach Using an Asymmetric Acetabular Component
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Revision Arthroplasty Through the Direct Anterior Approach Using an Asymmetric Acetabular Component

机译：通过使用不对称髋臼组分的直接前进方法来修复关节造身术

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Despite increasing numbers of primary hip arthroplasties performed through the direct anterior approach (DAA), there is a lack of literature on DAA revision arthroplasty. The present study was performed in order to evaluate outcomes and revision rates after revision through the DAA using an asymmetric acetabular component with optional intra- and extramedullary fixation. In a retrospective cohort study, we analyzed prospectively collected data of 57 patients (61 hips, 43 female, 18 male) who underwent aseptic acetabular component revision through the DAA with the abovementioned implant system between January 2015 and December 2017. The mean follow-up was 40 months (12–56). Survival rates were estimated using the Kaplan–Meier method. All complications were documented and functional outcomes were assessed pre- and postoperatively. Kaplan–Meier analysis revealed an estimated five-year implant survival of 97% (confidence interval CI 87–99%). The estimated five-year survival with revision for any cause was 93% (CI 83–98%). The overall revision rate was 6.6% (n = 4). Two patients had to undergo revision due to periprosthetic infection (3.3%). In one patient, the acetabular component was revised due to aseptic loosening four months postoperatively. Another patient suffered from postoperative iliopsoas impingement and was treated successfully by arthroscopic iliopsoas tenotomy. Two (3.3%) of the revised hips dislocated postoperatively. The mean Harris Hip Score improved from 35 (2–66) preoperatively to 86 (38–100) postoperatively ( p 0.001). The hip joint’s anatomical center of rotation was restored at a high degree of accuracy. Our findings demonstrate that acetabular revision arthroplasty through the DAA using an asymmetric acetabular component with optional intra- and extramedullary fixation is safe and practicable, resulting in good radiographic and clinical midterm results.
机译：尽管通过直接前进（DAA）进行了越来越多的原发性髋关节塑化术，但DAA修复关节造身术中缺乏文献。进行本研究，以评估通过使用不对称的髋臼组分在DAA通过DAA进行修改后进行蛋解和修订率，以任选的内部和髓外固定。在回顾性队列研究中，我们通过DAA分析了57名患者（61髋，43名女性，18名男性）的预期收集了57名患者（61名髋部，43名女性，18名男性），2015年1月至2017年1月和12月的上述植入系统。平均随访是40个月（12-56）。使用Kaplan-Meier方法估算生存率。记录了所有并发症，并且在术后和术后评估了功能结果。 Kaplan-Meier分析显示估计为97％的五年植入物存活率（置信区间CI 87-99％）。估计的五年生存率对任何原因的修订为93％（CI 83-98％）。整体修订率为6.6％（n = 4）。由于百血性感染（3.3％），两名患者不得不接受修正。在一名患者中，由于术后4个月，髋臼组分被修订。另一种患者患有术后Iliopsoas冲击，并通过关节镜Iliopsoas协调术成功治疗。术后两次（3.3％）的修订臀部脱臼。平均哈里斯髋关节评分从术后从35（2-66）增加到86（38-100）（P <0.001）。髋关节的解剖旋转中心以高精度恢复。我们的研究结果表明，使用不对称的髋臼成形术通过DAA具有可选的内部和髓内固定的髋臼修正关节成形术是安全可行的，导致良好的射线照相和临床中期结果。

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