全髋置换术中髋臼骨缺损的处理

Treatment of acetabular bone defect in total hip arthroplasty

目的 报道全髋置换术中髋臼骨缺损的处理方法。方法 1995年 6月～ 2 0 0 1年 6月分别用大块结构植骨、颗粒骨植骨、颗粒骨植骨 +cage或使用特殊髋臼处理 78例全髋置换术中髋臼骨缺损。 结果 平均随访 31.6个月 ,无论结构植骨还是颗粒植骨都能与受体骨愈合 ,除翻修和髋臼骨折骨缺损各 1例外 ,均未发现髋臼松动移位现象。平均Harris评分从术前 4 4分提高到术后 88分。结论 髋臼发育不良的骨缺损行结构性植骨 ,具有稳定髋臼、传递负荷的作用 ;全髋翻修时行颗粒骨植骨填补骨缺损 ,具有恢复旋转中心的作用。

Objective To report the result of treatment of acetabular bone defect in total hip arthroplasty. Methods From June 1995 to June 2001, structural bone grafting, morselized bone grafting, morselized bone grafting + cage or special acetabular prosthesis were used to repair the acetabular bone defect in 78 cases of total hip arthroplasty. Results A mean follow-up of 31.6 months revealed that the grafted bones, no matter structural or morselized, well united with the host bones without loosening of acetabular prosthesis,except 1 case each in revision and acetabular fracture with bone defect, respectively. The average Harris score was improved from 44 points preoperatively to 88 points postoperatively . Conclusion Structural bone graftng can stabilize the acetabular prosthesis and transfer loading in hip dysplasia patients. Morselized bone grafting in revision surgery can fill up the bone defects and restore the rotating center of the hip.