骨关节炎患者全髋关节置换术中筛眼技术的应用

Total hip arthroplasty with mesh technology and femoral head autografts for osteoarthritis with serious sclerosing acetabulum bone

目的：评价全髋关节置换术中结合筛眼技术治疗髋臼骨质严重硬化性髋关节骨关节炎的结果。方法：回顾性分析19例（21髋）患者行全髋关节置换术结合筛眼技术治疗髋臼骨质严重硬化性髋关节骨关节炎。男性12例，女性7例，平均年龄67岁。平均随访时间3年（24～60个月）。采用Harris评分对结果进行评估。术前及随访时进行摄片观察。根据全髋置换预期目标实现调查表评估患者术后随访满意度。结果：所有植骨块均获得愈合。无植骨块塌陷和髋假体松动。Harris评分由术前平均51分增加到88分。根据全髋置换预期目标实现调查表，患者术后满意度为89％。结论：结合筛眼技术加自体股骨头骨泥植骨重建髋臼侧的全髋关节置换术治疗髋臼骨质严重硬化性髋关节骨关节炎可获得良好结果。该方法髋臼固定可靠，可保留髋臼的骨量。

Objective： To evaluate the outcomes of total hip arthroplasty （THA） for osteoarthritis with serious sclerosing acetabulum bone with acetabular reconstruction of a mesh technology with a femoral head autograph. Methods： A retrospective study was made on 21 hips in 19 patients （12 male and 7 female： average age, 67 years） with osteoarthritis of hip treated by THA with use of a mesh technology. The average follow-up period was 3 years （range, 24-60 months）. An patients were evaluated with the use of a Harris hip score and Hospital for Special Surgery Hip Replacement Expectations Survey. Radiographic evaluations were made by preoperative and follow- up. Results： All autografts were seen to be united to host-bone. No collapse of the autograft and no hip had the evidence of loosening of component seen in all patients. According to the Hospital for Special Surgery Hip Replacement Expectations Surve）5 the average postoperative satisfaction was 89 at the final review. According to the Harris hip score, the average Harris hip score increased from 51 at preoperation to 88 at 2 years of follow-up. Conclusion： THA with use of an mesh technology in conjunction with a femoral head autograft for osteoarthritiswith serious sclerosing acetabulum bone could obtain favorable results. This method could provide reliable acetabular fixation and appeared to restore a cetabular bone stock in patients with osteoarthritis with serious sclerosing acetabulum bone.