植骨在髋臼骨缺损人工全髋关节置换中的应用

Bone grafting in total hip replacement in patients with acetabulum deficiency

目的探讨存在髋臼缺损的人工全髋关节置换(THR)中植骨的应用效果。方法对58例75髋存在髋臼骨缺损患者行全髋关节置换手术,术中对根据骨缺损的情况分别进行颗粒性、结构性和混合性植骨,术后对其中46例(59髋)进行髋关节X线检查及髋关节功能Harris评分。结果平均随访时间为45.6个月。X线检查显示54髋植骨处愈合,无明显骨吸收,占91.5%;5髋出现植骨边缘透亮带,占8.5%。术前Harris评分28～42分,平均34.18;术后髋关节功能,优:23例28髋,良:20例26髋,尚可:3例5髋,优良率91.5%。结论自体骨重建存在骨缺损的髋臼,增加了髋臼覆盖,提高了人工全髋置换术后髋臼假体稳定自性,近期临床效果好。

Objective To explore the clinical effect of bone grafting in total hip replacement（THR） for hips with acetabulum deficiency. Methods 58 patients （75 hips） with acetabulum deficiency had THR performed. In the operations, an ural bone graft, a morsehzed bone graft or their combination were used based on the definition. After the operations, 46 patients （59 hips） were followed up and evaluated by X-rays and the Harris score. Result During a follow-up of 45.6 months, 54 cases （91.53%） were cured, and 5 cases （8.47%） had bone graft absorption. The hip functions were excellent in 23 cases （28 hips）, good in 20 cases （26 hips） and fair in 3 cases（5 hips）. Conclusion Acetabulum reconstruction with auto graft in THA will bring good stability in patients with acetabulum deficiency, and also it is of significance in maintaining long-term function in the replaced hip.