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目的 探讨采用金属重建杯行髋关节翻修术的临床疗效.方法 回顾分析2006年10月-2013年10月,采用金属重建杯行髋关节翻修术的16例(16髋)患者临床资料.男4例,女12例;年龄49～ 78岁,平均62.7岁.初次人工全髋关节置换术至该次翻修术时间为3～15年,中位时间8.2年.翻修原因:假体无菌性松动15例,Vancouver B3型股骨柄假体周围骨折1例.髋臼侧骨缺损根据美国骨科医师协会(AAOS)分型:Ⅲ型12例,Ⅳ型4例;Paprosky分型:ⅢA型12例,ⅢB型4例.采用Harris评分评价髋关节功能,疼痛视觉模拟评分(VAS)评价术后大腿疼痛情况;摄X线片行影像学评价.结果 术后患者切口均Ⅰ期愈合;1例于术后2周发生下肢深静脉血栓形成,行抗凝治疗后治愈;无感染、神经血管损伤及脱位等并发症发生.16例均获随访,随访时间2～9年,平均6.8年.末次随访时Harris评分为(91.88±3.28)分,较术前(42.44±4.66)分显著改善(t=-106.30,P=0.00).2例术后下地行走时出现轻度大腿痛,症状于术后1年消失.术后即刻髋臼外展角为37～54°,平均42.9°;髋关节旋转中心距泪滴间线距离和距泪滴外侧距离分别由术前的(33.67±12.19) mm和(34.98±12.30) mm改善至术后即刻的(20.67±9.63) mm和(40.04±6.61) mm,比较差异均有统计学意义(t=-9.60,P=0.00;t=-3.15,P=0.00).术后4～ 12个月X线片示所有股骨大转子延长截骨区均获骨性愈合,随访期间金属重建杯与骨面均无连续性透亮带,无假体移位及骨溶解,臼杯均呈骨性固定;无1例因假体松动需行再翻修手术者.结论 对于臼杯假体松动合并髋臼骨缺损者,采用金属重建杯行翻修术可获得较好疗效.“,”Objective To explore the clinical outcomes of acetabular revision using a metal reconstruction cage.Methods Between October 2006 and October 2013,16 patients (16 hips) underwent acetabular revision with a metal reconstruction cage.There were 4 males and 12 females,with the mean age of 62.7 years (range,49-78 years).The time from total hip arthroplasty to revision was 3-15 years (mean,8.2 years).The causes for revision were aseptic acetabular loosening in 15 cases,and femoral periprosthetic fracture (Vancouver type B3) in 1 case.According to the American Academy of Orthopaedic Surgeons (AAOS) classification,there were 12 cases of type Ⅲ and 4 cases of type Ⅳ;according to the Paprosky classification,there were 12 cases of type ⅢA and 4 cases of type ⅢB.Harris score was used for hip function evaluation,and visual analogue scale (VAS) for pain in the thigh.X-ray films were taken for imaging evaluation.Results Healing of incision by first intention was obtained in all patients.Deep venous thrombosis occurred in 1 patient,and was cured after anticoagulation therapy.No complications of infection,neurovascular injury,and prosthetic dislocation were found.Sixteen patients were followed up 6.8 years on average (range,2-9 years).The Harris score was significantly increased from preoperative 42.44±4.66 to 91.88±3.28 at last follow-up (t=-106.30,P=0.00).Two patients had mild pain in the thigh,but pain disappeared at 1 year after operation.At immediate after operation,the abduction angle was 37-54° (mean,42.9°).The distance between acetabular rotation centre and teardrop line was (33.67± 12.19) mm for preoperative value and was (20.67±9.63) mm for postoperative value,showing significant difference (t=-9.60,P=0.00).The distance between acetabular rotation centre and lateral teardrop was (34.98± 12.30) mm for preoperative value and was (40.04±6.61) mm for postoperative value,showing significant difference (t=-3.15,P=0.00).X-ray film results showed bony fusion at the osteotomy sites at 4 to 12 months after operation.No continuous radiolucent line,prosthetic dislocation,or osteolysis was found,and bony ingrowth was observed in all patients.No patient received re-revision due to prosthetic loosening.Conclusion The metal reconstruction cage for acetabular revision can achieve good effectiveness for patients with serious bone defect.