严重后壁缺损的髋臼重建

Reconstruction for Bone Defect in Posterior Wall of the Acetabulum

目的探讨严重髋臼后壁缺损的患者在初次全髋置换或翻修术中髋臼重建的技巧。方法笔者自2009年4月至2011年5月对一组10例10髋被确诊为髋臼后壁严重缺损的患者进行全髋关节置换术或翻修术,全部采用自体或异体股骨头植骨修复骨缺损区并用骨盆重建钛板或螺钉固定然后植入生物固定型髋臼假体,术后进行至少12个月的随访并分别在第3、6、12、18、24、36个月拍摄X光片并记录Harris评分。结果本组所有病例术后第12个月或以上的X片证实假体臼的稳定性良好,无松动迹象,Harris评分疼痛选项得分全部满分。结论运用自体或异体股骨头植骨修复骨缺损区并用骨盆重建钛板或螺钉固定然后植入生物固定型髋臼假体,预期远期疗效良好。

Objective To explore the bone defect in posterior wall of the acetabulum in patients after primary total hip replacement or revision procedures in the acetabular reconstruction technique. Methods We reviewed ten patients with bone defect in the posterior wall of the acetabulum between April 2009 and May 2011. The defect of the posterior wall of the acetabulum was reconstructured with autologous or allogenic femoral head and fixed with titanium plate or screw and biological fixation of acetabular prosthesis. Postoperative at least 12 months of foUow-up, and should be evaluated by X-ray manifestations and Harris score at the 3, 6, 12, 18, 24, 36 month. Results The X-ray confirmed that no loose and the Harris score were all full marks. Conclusions The defect of the posterior wall of the acetabulum is reeonstructured with autologous or allogenic femoral head and fixed with titanium plate or screw and biological fixation of acetabular prosthesis with good expected lone-term curative effect.