Objective: To investigates the clinical efficacy of the trabecular metal acetabular revision system (TMARS) in one-stage reconstruction of acetabular deficiencies associated with periprosthetic joint infection (PJI). Methods: This is a retrospective case series study,including the data of 59 patients with PJI underwent acetabular defect reconstruction by TMARS during one-stage revisions in the Department of Orthopaedics, the First Affiliated Hospital of Xinjiang Medical University from January 2013 to December 2021. There were 32 males and 27 females, aged (59.5±14.6) years (range: 26 to 84 years). Among them, 29 cases used tantalum cups, 13 cases used tantalum cups and tantalum reinforcing blocks, 9 cases used cup-cage, and 8 cases used multi-cup reconstruction techniques. The surgery procedure, Harris Hip score (HHS), recovery of the hip rotation center, implant survival rate, postoperative reinfection rate, and complications were recorded. Data were compared using the Wilcoxon rank-sum test. Results: All of the 59 patients underwent the operations successfully. Operation time was (188.9±48.4) minutes (range: 110 to 340 minutes), and intraoperative bleeding volume was (M(IQR)) 1 000(400)ml (range: 600 to 1 800 ml). After a postoperative follow-up of 5.1 (2.6) years (range: 2.0 to 10.5 years), the prosthesis survival rate was 94.9% (56/59). Recurrence of infection occurred in 3 cases (5.1%), aseptic loosening in 1case(1.7%), and hip dislocation in 4 cases (6.8%). At the last follow-up, HHS improved significantly(84 (12) vs. 44 (9), Z=-6.671, P<0.01), and the center of rotation of the hips were recovered in all cases. Conclusions: In one-stage revision surgeries aimed at reconstructing acetabular defects, utilizing the TMARS can provide stable initial fixation, restore a more natural center of rotation, significantly enhance early postoperative hip joint function, and reduce the likelihood of infection recurrence. This approach stands as a reliable choice for addressing acetabular defects during revision surgeries for infected hip joints.
目的： 探讨髋关节假体周围感染（PJI）一期翻修术中应用钽金属骨小梁髋臼系统（TMARS）重建髋臼缺损的临床效果。 方法： 本研究为回顾性病例系列研究。回顾性分析2013年1月至2021年12月新疆医科大学第一附属医院关节外科诊断为PJI并在一期翻修术中采用TMARS行髋臼缺损重建的59例患者资料。男性32例，女性27例，年龄（59.5±14.6）岁（范围：26~84岁）。其中单纯使用钽杯29例、钽杯联合钽金属加强块13例、髋臼杯联合髋臼加强环罩技术9例、多杯重建技术8例。记录患者手术情况、Harris髋关节评分、髋关节旋转中心恢复情况、植入物存活率及术后并发症情况等。数据比较采用Wilcoxon符号秩检验。 结果： 59例患者均顺利完成手术。手术时间（188.9±48.4）min（范围：110~340 min），术中出血量［M（IQR）］1 000（400）ml（范围：600~1 800 ml）。术后随访5.1（2.6）年（范围：2.0~10.5年），假体存活率为94.9%（56/59）。发生术后再感染3例（5.1%），无菌性松动1例（1.7%），髋关节脱位4例（6.8%）。末次随访时，HHS较术前明显改善［84（12）分比44（9）分，Z=-6.671，P<0.01］，髋关节旋转中心均得到有效恢复。 结论： TMARS应用于一期翻修重建髋臼缺损，能恢复髋关节的初始稳定，重建相对正常的旋转中心，改善术后髋关节功能，感染复发率较低，是感染髋关节翻修术中重建髋臼缺损的可选方案。.