加压植骨技术在先天性髋关节发育不良患者全髋置换术中修复髋臼缺损的应用

Impaction Grafting for Acetabular Deficiency in Total Hip Arthroplasty for Congenital Hip Dysplasia: A Surgical Technique

目的介绍加压植骨技术在先天性髋关节发育不良（congenital hip dysplasia，CDH）全髋关节置换术中修复髋臼缺损的应用，并对其临床早期效果进行评估。方法2012年8月～2013年5月我院对15例（15髋）CDH患者施行该术式。对患者手术前后X线结果进行分析，应用Harris评分评价手术前后髋关节功能。结果本组患者术前患髋Harris评分平均为（45．2±10．6）分，术后3月随访提高到（81．1±16．5）分，术后未出现感染、脱位等早期并发症。结论通过联合应用加压植骨、钛网固定及骨水泥加压技术，患者髋臼形态得以重建，术后恢复良好。多种技术的联合应用在CDH患者全髋置换术中具有重要意义。

Objective To introduce a surgical technique incorporating the impaction bone graft, mesh and cemented technique to reconstruct hip center for congenital hip dysplasia （CHD） patients and reveal some tips of the technique for the severe deficiency of the acetabulum. Methods All 15 CHD patients were per- formed total hip arthroplasty（THA） combining the impaction bone graft, mesh and cemented technique. The detail of the surgery was compared by the X-ray results of the pre- and post-operation. Then the hip functions were assessed according to Harris score. Results The Harris scores of the patients were increased from aver- age 45.2 ± 10.6 to average 81.1 ± 16.5. No early complications such as infection or dislocation were found af- ter the surgery. Conclusion The technique incorporating the impaction bone graft, mesh and cemented tech- nique should be regarded as a valuable alternative in THA for CHD.