颗粒骨打压植骨结合钛网治疗全髋关节置换术后髋臼侧骨缺损的近期疗效

The short-term efficacy of impaction bone grafting combined with titanium mesh in treatment of acetabular defects after total hip arthroplasty

目的探讨同种异体颗粒骨打压植骨结合钛网治疗全髋关节置换术(THA)后髋臼侧骨缺损的临床疗效。方法 THA后髋臼骨无菌性松动缺损患者18例。Paprosky分型:ⅡA型10例,ⅡB型5例,ⅡC型2例,ⅢB型1例。采用同种异体颗粒骨打压植骨结合钛网、骨水泥臼重建髋臼。手术前、手术后及术后每年采用Harris评分评估髋关节功能,通过影像学检查评估植骨固定效果。结果 15例获得随访12-60个月。末次随访时Harris髋关节评分较术前提高[(90.80±6.83)分vs.(46.80±6.06)分](P<0.01)。影像学检查发现植骨与宿主骨结合良好,髋臼杯均无明显影像学松动。结论同种异体颗粒骨打压植骨结合钛网治疗THA后髋臼侧骨缺损可获得良好的效果。

Objective To evaluate the short-term efficacy of impaction bone grafting combined with titanium mesh in the treatment of acetabular defects after total hip arthroplasty（THA）. Methods The acetabular defects induced by aseptic loosening occurred in 18 patients underwent THA, who were with Paprosky Ⅱ A defects in 10 cases,Paprosky Ⅱ B defects in 5 cases,Paprosky Ⅱ C defects in 2 cases and Paprosky ⅢB defects in 1 case. The patients were treated with titanium mesh, impaction grafting and a cemented cup and the short-term efficacy was evaluated by Harris hip scoring systerm. Results Fifteen patients were followed up for 12 to 60 months,which showed that Harris score was elevated from （46.80±6.06） points before to （90. 80±6.83） points at the last follow-up（P〈0. 01）. X-ray imaging showed that the position of prostheses was satisfactory without loosening of prostheses and bone block resorption. Conclusion Impaction bone grafting combined with titanium mesh is effective in the treatment of acetabular defects.