缝匠肌骨瓣修复人工全髋关节置换中髋臼缺损的实验研究

Establishment of animal model of the sartorius iliac flap for the repair of segmental acetabular bone defects in the total hip replacement

目的建立缝匠肌骨瓣修复人工全髋关节置换(THR)中髋臼节段性缺损的动物模型,并观察其初步修复结果。方法16只成年山羊进行左侧THR,并造成髋臼上方负重区40%的节段性骨缺损。随机分成2组,分别以缝匠肌髂骨瓣和游离髂骨瓣移植修复,术中行骨瓣血运、带血管蒂缝匠肌骨瓣活动长度的观察,术后行大体、X线和组织学观察。结果术中缝匠肌髂骨瓣血运良好,有足够的活动长度;术后X线显示移植骨块及置换假体位置良好,固定牢靠;缝匠肌髂骨瓣仍然保持基本正常松质骨结构,与髋臼可以形成类似骨折愈合的连接。结论缝匠肌骨瓣可以很好地修复髋臼节段性缺损,效果优于游离骨瓣。

Objective To establish an animal model of the sartorius iliac flap for the repair of segmental acetabular bone defects in total hip replacement,and observe preliminary repair result on them. Methods The 40% segmental acetabular bone defects on superior weight loading area were made for 16 ripe goats in total hip replacement, and they were randomly divided into two groups：the defects were repaired with the sartorius iliac flap and the free iliac flap. The blood supply and activity length of the sartorius muscular iliac flap were observed at the time of operation,X-ray and histology were observed postoperatively. Results Blood supply of the sartorius iliac flap was good, activity length was enough. X-rays showed the position of the bone graft and prosthesis was good, and the fixation was stable. The iliac flap can keep its structure similar to cancellated bone, and the connection between the iliac flap and acetabular bone was similar to fracture healing. Conclusion The sartorius iliac flap can well repair segmental acetabular bone defects in total hip replacement and the effect is superior to the free iliac flap.