全髋关节翻修术中髋臼缺损的重建

Reconstruction of the acetabular defects with reinforcement plate or titanium net in the revision of the total hip joint arthroplsty

目的 :在全髋关节翻修术中 ,通过打压植骨、髋臼钢板或金属钛网对髋臼骨缺损进行重建 ,以恢复髋臼的完整性 ,提高髋臼假体的稳定性。 方法 :全髋关节翻修术 38例 ,其中 12例采用自体或异体骨植骨、髋臼重建钢板或金属钛网固定 ,对重建后的髋臼进行支撑和加强。 结果 :12例患者术后随访 3～ 38(平均 13.1)个月 ,X线片表明髋臼侧植骨处仅 1例出现轻度骨吸收 ,其余骨愈合良好 ,未出现骨吸收和内固定移位。 结论 :对于髋关节翻修中 ,对髋臼骨缺损者采用打压植骨、髋臼钢板或金属钛网支撑加强 ,重建髋臼的骨性结构是一种有效的方法 。

Objectives:To reconstruct the defects of acetabulum in the revision of total hip joint arthroplasty (THA) in an effort to restore the anatomy of acetabulum and improve the stability of acetabular prosthesis. Methods:From January 1977 to January 2002, 38 revisions of THA were performed, of which 12 cases had bone defects in the acetabulum and were reconstructed by using allograft or selfgraft reinforced with plate or titanium net for restoring the bone structure. Results:The average age of the 12 patients was 64 years and the follow up care lasted for an average of 13.1 months (ranging from 3 to 38 months). By X ray examination, favorable healing of allografted or selfgrafted acetabulum without any bone resorption was found in all but one patient. Conclusions:It is a useful and reliable method to restore the structure of acetabulum with allograft or selfgraft, reinforcement plate or titanium net during the THA revision.