生物臼盖的研制与临床应用

Design and Clinical Application of Bio-acetabular Roof

目的研制生物臼盖并将其用于治疗发育性髋关节发育不良患儿。方法采用异种皮质骨加工制成生物臼盖主体及生物螺钉,并将其应用于2～10岁发育性髋关节发育不良儿童13例(16髋)。术后定期复查,随访终末时,采用Mckay临床疗效评定标准和SeverinX线影像学评定标准评价复位后髋关节的功能及发育情况。结果所有病例均获得18个月以上随访。随访终末时,Mckay临床疗效评定结果,优9髋,良6髋,可1髋,优良率为94%;SeverinX线影像学评定结果,优9髋,良4髋,可3髋,优良率为81%。本组无一例发生术后再脱位、股骨头骨骺缺血性坏死、再骨折、髋关节僵硬等严重并发症。结论经临床初步观察,生物臼盖能有效维持复位后髋关节的稳定,增大头臼接触面积,增加髋臼对股骨头的包容,为髋关节的发育塑形提供良好的生物力学环境。

Objective To design and evaluate the efficiency of the bio- acetabular roof for the treatment of developmental dysplasia of the hip in children. Methods The bio - acetabular roof comprised two parts, the bio - acetabular roof body and the bio - screw, which was made with heterogenetic cortex and performed for the treatment of developmental dysplasia of the hip in 13 children （16 hips） aged between 2 to 10 years old. The regular follow up and evaluation the function and development of the hip joint were done by Mckay clinical effect criteria combined with Severin radiographic standards at final follow - up. Results All the patients were followed up for more than 18 months. The Mckay clinical evaluated efficiency： the ratio of the excellent and good results was 94% , and the excellent result was achieved in 9 hips, good in 6 hips and fair in one hip. Based on the Severin radiographic standards, the ratio of the excellent and good results was 81%, 9 hips were excellent, 4 hips good, and 3 hips fair. There were no severe complications after operation, such as re - dislocation, the femoral head avascular necrosis, refracture, the ankylosis of the hip joint, and so on. Conclusion The bio - acetabular roof can maintain effectively the stability of the hip joint, augment the contacted areas of femoral head and acetabulum, increase the containment of the acetabulum to femoral head, provide excellent biomechanical environments for develop, and the remolding of the hip joint through the clinical preliminary observation.