评估在全髋关节翻修术中应用钽金属Jumbo杯重建严重Gross型髋臼骨缺损的早期临床疗效。

回顾性分析了从2012年10月至2016年5月在山西医科大学第二医院关节外科使用钽金属Jumbo杯实施髋关节翻修手术患者17例。男6例，女11例，年龄49～78岁，平均(68± 7)岁。纳入标准：单侧初次翻修(对侧髋关节正常)；翻修原因均为无菌性松动；Gross Ⅲ型和Gross Ⅳ型使用Jumbo杯翻修。排除标准：缺血性骨坏死；假体与宿主骨接触面积<30%；任何原因导致的失访。观察其髋关节Harris评分、髋臼外展角变化、髋臼旋转中心(水平及垂直方向位移)变化等情况及并发症，使用SPSS 22.0统计学软件包对手术前后计量指标进行配对t检验。

所有患者均获得随访，随访时间(29±14)个月。没有出现假体松动，感染等并发症，只有1例患者于术后5 d后脱位，腰麻下闭合复位，术后皮肤牵引4周，至末次随访未发生脱位。术前Harris评分(32.8±4.8)分，末次随访时(87.1±4.7)分，差异有统计学意义(t＝62.46，P<0.05)。髋臼外展角和位移变化分别小于4°和4 mm，患侧髋臼中心(垂直距离和水平距离)，末次随访时和术前相比，差异有统计学意义(t＝10.95，P<0.05；t＝5.53，P<0.05)。末次随访时健患侧髋臼旋转中心位置相比，差异无统计学意义(t＝1.78，P>0.05；t＝0.44，P>0.05)。术后髋臼旋转中心相比术前得到明显改变，与健侧相比差异不明显，基本重建了正常的髋臼旋转中心。

钽金属Jumbo杯增加与宿主骨接触面积，假体植入技术简单，减少植骨量，最大限度恢复旋转中心，臼杯骨长入快，可以取得显著的早期临床疗效。

To evaluate the early clinical effect of the reconstruction of severe Gross dislocation of acetabular bone in the reconstruction of hip arthroplasty.

From October 2012 to May 2016, 17 cases of hip arthroplasty were performed in the Second Hospital of Shanxi Medical University. There were six males and 11 females, aged from 49 to 78 years, (68±7) years on average. Inclusion criteria: unilateral primary revision (normal opposite hip joint); the reasons for renovation were aseptic loosening; Gross Ⅲ type and Gross Ⅳ patients using Jumbo cup renovations. Exclusion criteria: ischemic osteonecrosis; the contact area between the prosthesis and the host bone is less than 30%; any loss of visit for any reason. The complications, Harris score, the change of the external angle of the acetabulum, and the acetabular rotation center were observed. Paired t test was performed for preoperative and postoperative measurement indexes using SPSS.22.0 software.

All the patients were followed up. One patient experienced postoperatively hip dislocation postoperatively on the 5^th day, which was resolved after a closed reduction and a 4-week skin traction treatment. Until the end of the follow-up, the dislocation did not recur. There was no infection, loosening or other complications. The Harris hip score was (32.8±4.8) preoperatively and (87.1±4.7) postoperatively (t=62.46, P <0.05). Acetabular abduction angle variation was less than 4°, displacement of acetabulum was less than 4 mm. The preoperative acetabular center (vertical distance and horizontal distance) comparing with the data of last follow-up showed a statistically significant difference (t=10.95; t=5.53; all P<0.05). At the last follow-up, the difference in acetabular rotation center location between the contralateral side and ipsilateral side was not statistically significant (t=1.78, P>0.05; t=0.44, P>0.05). After the operation, the rotational acetabular center returned to normal comparing with the healthy side.

The contact area of the host bone can be increased by tantalum metal Jumbo cup, the prosthesis implantation technique is simple with less bone graft, the rotation center can be restored to the maximum, and the bone cup can regenerate rapidly, which suggest that early clinical efficacy can be achieved.