摘要
目的总结髋臼加强环(Cage)联合同种异体骨植骨重建髋臼在髋关节翻修术中的应用及疗效。方法 2006年2月-2010年8月,对14例(14髋)行人工全髋关节翻修术的重度髋臼骨缺损患者采用Cage联合同种异体骨植骨重建髋臼。男6例,女8例;年龄45～76岁,平均59.2岁。初次置换至此次翻修术时间为5～12年,平均7.2年。翻修原因:感染8例,骨溶解及假体松动6例。术前髋关节功能Harris评分为(37.7±5.3)分。髋臼骨缺损按照美国骨科医师协会(AAOS)分型标准:Ⅲ型8例,Ⅳ型6例。结果术后切口均Ⅰ期愈合,无坐骨神经损伤、下肢深静脉血栓形成等并发症发生。患者均获随访,随访时间14～62个月,平均44个月。患者疼痛症状均明显缓解或消失。末次随访时髋关节Harris评分为(89.7±3.2)分,与术前比较差异有统计学意义(t=—44.40,P=0.04)。X线片示髋臼假体均无松动,植骨未见明显吸收,并逐渐与宿主骨融合。结论在髋关节翻修时,采用Cage联合同种异体骨植骨能有效修复髋臼骨缺损并重建髋臼,近期疗效满意,远期疗效尚需进一步随访观察。
Objective To evaluate the effectiveness of acetabulum reinforcement ring （Cage） with allograft bone for reconstructing acetabular defects in hip revision. Methods Between February 2006 and August 2010, 14 patients （14 hips） with serious acetabular bone defects after total hip arthroplasty underwent acetabular reconstruction by using Cage with aUograft bone. There were 6 males and 8 females with a mean age of 59.2 years （range, 45-76 years）. The mean time between first replacement and revision was 7.2 years （range, 5-12 years）. The revision causes included infection in 8 cases, osteolysis and aseptic loosening in 6 cases. The hip function Harris score was 37.7 ：i： 5.3. According to America Association of Orthopedic Surgeon （AAOS） standard, the acetabular defect was classified as type Ⅲ in 8 cases and as type Ⅳ in 6 cases. Results All incisions healed by first intention, and no complication occurred. The patients were followed up 14-62 months （mean, 44 months）. The pain was relieved or disappeared. At last follow-up, the Harris score was 89.7 ± 3.2, showing significant difference when compared with preoperative score （t=-44.40, P=0.04）. No loosening of the acetabular component or osteolysis was found in 14 hips. No absorption or coUapse of the allograft was observed in aU patients. Conclusion Cage with allograft bone is a useful method of reconstructing acetabular bone defects in hip revision. Further follow-up is needed to assess the long-term effectiveness.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2012年第8期902-904,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
髋关节翻修
髋臼骨缺损
髋臼重建
髋臼加强环
Hip revision Acetabular bone defect Acetabular reconstruction Acetabulum reinforcementring
