摘要
[目的]总结髋置换后感染二期翻修中采用异体骨嵌压植骨技术重建骨缺损的病例,分析临床及X线片结果,探讨异体骨植骨重建在髋关节感染二期翻修中应用的安全性及有效性。[方法]本组共4例5髋采用异体骨嵌压植骨重建感染的髋关节,平均随访14.5个月,对临床结果进行Harris评分,并对X线片进行分析。[结果]截至最后1次随访,所有病人均无感染迹象。Harris评分术前平均25.75分,术后平均82.75分,平均改善57分,肢体长度平均矫正3.1cm,术后优良率为50%。所有病例正侧位X线片上均未见假体移位、下沉,无透光线,股骨侧无股骨距处骨吸收。3例病人发生并发症,包括股骨假体穿出、脱位和外展肌无力。[结论]在髋置换感染的二期翻修中采用异体骨植骨重建是一种比较安全和可行的方法,能够获得较满意的感染控制结果和功能结果,但是该方法技术要求高,并发症发生率高,需要医生有丰富的经验和较长期的学习过程。
[Objective] To analyze the cases with impacting bone grafting in second-stage revision for infected total hip, and to evaluate the safety and effect of allograft in the periprosthesis infection. [Method] A second-stage revision was carried out in 4 patients (5 hips) with confirmed infection in hip replacements. Allograft bone was used in the operation. Pathogenic organism were identified in all cases. The Harris score and X ray checking result were analyzed. [Result] The mean follow up time was 14.5 months. No re-infection was found during the follow-up. The mean Harris score was 25.75 points preoperatively and 82.75 points postoperatively, which had increased for 57 points averagedly , and the enlongation of affected limb was 3.1cm. The X ray checking results showed no phenomenon of displacement and subsidence of prosthesis and no lucency line and bone absorption. Complications were found in 3 patients. [Conclusion] Allograft has been proved safe and useful in infected hip replacement with considerable loss of bone stock, but it is still a technique demanding operation.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2005年第14期1066-1068,共3页
Orthopedic Journal of China
