大直径多固定孔臼杯在人工髋关节翻修术髋臼骨缺损结合植骨中的应用

Application of combined large-diameter porous acetabular cup and bone graft in repair of acetabular defects during revision hip arthroplasty

目的探讨人工髋关节翻修术髋臼周围骨量储备或缺损的处理经验及选取生物型大直径多固定孔臼杯应用。方法选取辽宁本溪第一人民医院2008年5月-2012年4月期间髋关节翻修术中存在不同程度髋臼骨缺损共32例(34髋),骨缺损类型为Paprosky Ⅱ、Ⅲ型。我们采用大直径多孔臼杯结合植骨修复骨缺损,恢复髋臼旋转中心。结果平均随访3.2(2.5～3.67)年,Harris评分18髋>90分,13髋为80～89分,2髋为70～79分,1髋<70分,优良率达88.6%。结论大直径多孔臼杯结合植骨处理髋关节翻修术中严重髋臼骨缺损,中期效果良好。

Objective To study the application of large-diameter porous acetabular cup in repair of acetabular bone loss or defects during revision hip arthroplasty and summarize our experience with it. Methods Thirty-two patients （34 hips） with different degrees of Paprosky types II and III acetabular bone defects admitted to our hospital from May 2008 to April 2012 for revision hip arthroplasty were included in this study. Their acetabular bone defects were repaired with combined large diameter porous cup and bone grafts with the acetabular rotation center restored. Results The patients were followed up for 2.5 -3.67 years （mean 3.2 years）. The Harris score was 〉 90, 80-89, 70-79 and 〈 70 for 18, 3, 2 and 1 hips, respectively, with an excellent and good curative efficacy of 88.6%. Conclusion The intermediate- and long-term effect of combined large-diameter porous cup and bone graft on severe acetabular bone defects is good.