探讨金属小梁加强块（augment）在PaproskyⅢ型复杂髋臼骨缺损翻修中的临床应用价值，评估其构建术中稳定性、重建髋臼旋转中心及恢复髋关节功能的效果。

回顾性分析2016年1月至2022年12月浙江省中医院收治的PaproskyⅢ型髋臼骨缺损翻修患者。纳入标准：年龄≥18岁；既往接受全髋关节置换术，因假体松动或骨溶解需行髋臼侧翻修；影像学提示Paprosky Ⅲ型髋臼骨缺损；随访资料完整，随访时间≥12个月。排除标准：合并感染或既往假体周围感染未治愈；严重并存病不能耐受手术；病理性骨折或肿瘤相关骨缺损；临床及影像资料不完整。共纳入6例，其中ⅢA型3例采用金属小梁加强块联合多孔钽金属臼杯重建，ⅢB型3例采用加强笼联合加强块重建。记录髋关节旋转中心相对解剖旋转中心的垂直偏移量与水平偏移量，并依据影像学征象评价假体稳定性。记录术中出血量、手术时间、并发症发生情况及术前与末次随访时的Harris评分各维度数据，分析其疗效与安全性。数据分析采用配对样本t检验或采用Wilcoxon符号秩检验。以P<0.05为差异有统计学意义。

所有患者均获得随访，末次随访时假体位置稳定，未见脱位、螺钉断裂或明显迁移，影像学提示骨长入征象满意。末次随访Harris总评分由术前（54.2±4.2）分提高至（86.9±3.0）分，差异具有统计学意义（t=12.18，P<0.01）。其中疼痛评分由（15.5±5.7）分提高至（40.0±3.2）分（t=9.36，P<0.01），功能评分由（31.8±5.3）分提高至（39.0±4.5）分（t=3.74，P<0.05）。髋关节旋转中心垂直偏移量由术前（20.1±3.7）mm降至末次随访（6.9±2.5）mm（t=8.47，P<0.01），水平偏移量由（10.8±2.9）mm降至（4.7±2.0）mm（t=6.92，P<0.01）。

加强块在Paprosky Ⅲ型复杂髋臼骨缺损翻修术中具有良好的力学支撑与骨整合能力，尤其在Ⅲ型不同亚型中可实施差异化策略；短中期随访效果理想。

To investigate the clinical value of trabecular metal augments in revision surgery for Paprosky typeⅢcomplicated acetabular bone defects, and evaluate the effectiveness in intraoperative stability, the acetabular rotation center reconstruction, and hip function improvement.

A retrospective analysis was conducted on patients with Paprosky typeⅢacetabular bone defects who underwent revision surgery at Zhejiang Provincial Hospital of Traditional Chinese Medicine between January 2016 and December 2022. Inclusion criteria: age≥18 years; total hip arthroplasty history requiring acetabular revision due to prosthetic loosening or osteolysis; radiographic confirmation of Paprosky typeⅢacetabular bone defects; complete follow-up data with a follow-up duration of at least 12 months. Exclusion criteria: active infection or unresolved previous periprosthetic joint infection; severe comorbidities precluding surgical tolerance; pathological fractures or tumor-related bone defects; incomplete clinical or radiographic data. A total of six patients were enrolled. Among them, three patients with typeⅢA defects underwent reconstruction using trabecular metal augments combined with a porous tantalum metal cup, while three patients with typeⅢB defects were treated with a cage combined with an augment. The vertical and horizontal offsets of the hip center relative to the anatomical hip center were measured, and implant stability was evaluated based on radiographic findings. Intraoperative blood loss, operative time, perioperative complications, and domain-specific Harris hip scores before surgery and at the final follow-up were recorded to assess clinical efficacy and safety. Statistical analysis was performed using paired t tests or the Wilcoxon signed-rank test as appropriate. Difference was considered statistically significant if P<0.05.

All the patients completed the follow-up. At the final follow-up, implant position remained stable, with no evidence of dislocation, screw breakage, or obvious migration, and radiographic findings indicated satisfactory osseointegration. The total Harris score increased from the (54.2±4.2) before operation to (86.9±3.0) at the final follow-up (t=12.18, P<0.01). Pain scores improved from (15.5±5.7) to (40.0±3.2) (t=9.36, P<0.01), and function scores improved from (31.8±5.3) to (39.0±4.5) (t=3.74, P<0.05). The vertical offset of the hip center decreased from (20.1±3.7) mm before operation to (6.9±2.5) mm at the final follow-up (t=8.47, P<0.01), while the horizontal offset decreased from (10.8±2.9) mm to (4.7±2.0) mm (t=6.92, P<0.01).

Augment provides effective mechanical support and favorable osseointegration in revision surgery for Paprosky typeⅢ complex acetabular defects, enabling subtype-specific reconstruction strategies across different Paprosky Ⅲ subtypes. Short- to mid-term follow-up outcomes were satisfactory.