中文摘要：

目的探讨全髋关节翻修术中采用jumbo臼杯重建髋臼骨缺损的疗效。方法回顾性分析2006年1月至2015年12月于全髋关节翻修术中采用jumbo臼杯重建髋臼骨缺损的患者48例，男19例，女29例；年龄39~82岁，平均（62~12）岁。单侧47例，双侧1例。髋臼骨缺损Paprosky分型：Ⅱ型27髋，ⅢA型18髋，ⅢB型4髋。翻修原因：髋臼感染后二期翻修8髋，髋臼无菌性松动41髋。均采用jumbo臼杯进行重建，对ⅡB型以上骨缺损进行植骨，植骨采用自体松质骨或异体骨混合嵌压和底部填塞13髋、异体松质骨植骨钛网固定5髋、金属骨小梁垫块4髋。36髋同时行股骨侧假体翻修。随访时摄X线片评估臼杯稳定性及假体旋转中心变化，以Harris髋关节评分评估临床疗效。以Kaplan-Meier生存曲线分析假体5年生存率。将患者分为松动失败和未失败两组，采用Cox回归分析外展角、旋转中心位置与失败的相关性。结果随访1~11年，平均6.8年。术前Harris髋关节评分（47．6±7．1）分，末次随访时提高至（82．4±6．2）分，差异有统计学意义（t=-31．42，P=0．00）。5髋患者在术后5年内出现手术失败，假体5年生存率为89．8％±4．4％。2髋（Paprosky ⅢA型）术后出现感染，行再次翻修；2髋（PaproskyIIIA型1髋、Paprosky ⅢB型1髋）出现假体松动，行再次翻修；1髋（Paprosky ⅢB型）术后出现明显的髋部行走时疼痛，经保守治疗及康复锻炼后症状轻度好转，未行再翻修。放射学测量的髋臼外展角与手术失败无相关性（r==0．06，P=0．53），髋臼翻修后旋转中心的垂直位移、水平位移与手术失败无相关性（r=0．11，P=0．14；r=0．04，P=0．89）。2髋出现术后脱位，1髋经保守治疗后未复发、1髋由股骨侧假体再松动引起而再次行股骨侧翻修。结论采用jumbo臼杯修复髋臼骨缺损患者的早中期疗效好，具有手术操作相对简单、减?

英文摘要：

Objective To investigate the effects of the jumbo cup in acetabular revision for patients with massive acetab- ular bone deficiency. Methods We retrospectively studies 48 patients （49 hips） who underwent jumbo cup revisions between 2006 and 2015 （19 men and 29 women; average age： 62±12 years）. The acetabular bone defects were classified according to Paprosky classification （Paprosky Ⅱ 27 hips, Paprosky ⅢA 18 hips, Paprosky ⅢB 4 hips）. Radiological assessments were conduced to evaluate the acetabular prosthesis loosening, dislocation and infection. The reasons for revisions were mechanical loosening in 41 cases, and infections in another 8 cases with cement spacer putted by last surgery. Results The operation duration and blood loss was 110 min （85-160 min） and 315 ml （270-455 ml） respectively. After an average follow-up of 6.8 years （1-11 years）, Harris hip score was increased from 47.6±7.1 preoperatively to 82.4±6.2 postoperatively. Osseointegration occurred in the acetabular components at 6 months postoperatively. Radiograph analysis showed satisfied position of acetabular cup without complications such as damages of vessels or nerves. The successful rate of jumbo cup revisions was 89.8%±4.4%. However, two in Paprosky IIIA failures for periprosthetic infection occurred and two in Paprosky ⅢA, one in Paprosky IIIA and the other in Paprosky IIIB for ace- tabular component loosening. One patient in Paprosky IIIB had weight-bearing pain and relieve slightly after conservative treat- ment. The radiologic study showed that there was no relationship between failure rate and acetabular abduction angle （r=-0.06, P= 0.53）, rotation center migration in vertical direction （r=0.11, P=0.14） and horizontal direction （r=-0.04, P=0.89）. Conclusion The mid-term results show that using jumbo cup in revising acetabular failure with massive bone deficiency are optimal, which can be achieved by simplified operation procedures, reduction in the need of bone graft and promotion in acet