| Objective:To investigate the short-term clinical results of surgical reconstruction of severe Gross acetabular bone deficiency using tantalum Jumbo cup in revision THA.Methods:From May 2012 to October 2016,a group of 32 patients with Gross Ⅲ and Gross Ⅳacetabular bone deficiency were enrolled in this study.On the method of surgery,they were divided into two groups.Biological stem prosthesis was used in control group(n=15),and tantalum Jumbo cup was used in treatment group(n=17).Harris hip scores,the change of inclination of acetabular components,the migration of the hip center and the leg length difference were recorded,and the complications were evaluated at follow-up.Results:Clinical evaluation: All the patients were followed up for 13-53 months,average(29±14)months.Harris scores in all patients increased after treatment(P <0.05).Moreover,harris score in treatment group was significantly higher than that in control group(P <0.05).Image evaluation: Compared with the hip center of 48 hours after the operation,the mean change of abduction angle,the mean change of vertical migration and vertical migration in treatment group were lower than those in control group(P<0.05).The leg length difference in all patients decreased after treatment(P<0.05).Moreover,the leg length difference in treatment group was lower than that in control group(P <0.05).The position(horizontal and vertical)of the acetabulum in all patients at the follow-up was significantly altered after treatment(P<0.05).There was no obvious difference in the position(horizontal and vertical)of the acetabulum between the two groups before the operation(P>0.05).The difference in the horizontal position between the two groups was not obvious(P>0.05),and there was a difference in the vertical position after the operation(P<0.05).Thus,both can reconstruct acetabular center and obtain firm initial stability.All tantalum jumbo cups in treatment group were well fixed based on the radiograph imaging results.No one had radiographic evidences of loosening and migration.Thehorizontal displacement and vertical displacement of acetabulum were less than 4mm.the change of abduction angle was less than 4°.In the control group,there were 2 cases whose abduction angle change greater than 4mm,and the horizontal displacement of 1 case was greater than 7mm,which could be diagnosed as acetabulum loosening.There are 3 patients with acetabular side with less than 2mm transmission line,and it is suggested that the acetabulum shift and loosening probability will be greater,the long-term survival rate is worrying.Complications: In treatment groups,one patient experienced postoperatively hip dislocation after 5 days that was resolved after a closed reset.Until the end of the follow-up period,the dislocation did not recur.In control groups,One patient underwent wound healing delay and 2 cases of lower limb deep vein thrombosis,and recovered after treatment.There was no infection,nerve injury or perioprosthetic fracture complications in all patient.Conclusion :Tantalum Jumbo acetabular components offer numerous advantages in revision of severe acetabular defects.Owing to the large size of the component,the need for bone graft is reduced.The technique is also more likely to restore an anatomical centre of rotation of the joint.It can obtain good short-term therapeutic effect.The long-term clinical efficacy in treatment groups was significantly higher than that incontrol groups. |
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