自体骨植骨修复初次膝关节置换中胫骨平台内侧包容性骨缺损

Autologous bone graft to repair tibial plateau bone defects in primary total knee arthroplasty

目的观察利用初次全膝关节置换术中截骨获得的自体骨植骨的方式修复胫骨平台内侧包容性骨缺损的近期疗效。方法选取2012年9月-2013年12月9例（10膝）膝骨关节炎合并内侧胫骨平台包容性骨缺损行全膝关节置换术患者。胫骨平台骨缺损采用自体骨植骨的方式修复,常规骨水泥固定胫骨假体,缺损的植骨部位完全覆盖于假体下。结果随访时间3月-2年,平均1.4年,HSS（Hospital for special surgery,HSS）膝关节评分由术前36.7（31-54）分,提高到84.7（76-94）分。术后X线片显示胫骨骨缺损得到有效修复,假体下方无骨质缺损表现。近期随访无感染征象,X线片未见假体松动、植骨块移位及吸收。结论自体骨植骨可有效的修复全膝关节置换术中胫骨平台内侧包容性骨缺损。

Objective To observe the short-term outcome of autologous bone graft to repair tibial plateau bone defects in total knee arthroplasty（TKA）. Methods Collect 9 osteoarthritis patients（10 knees） with tibial plateau bone defects from September 2008 to December 2011 whom underwent total knee arthroplasty. During operation, the bone defect of tibial plateau was repaired by autologous bone graft. Conventional bone cement fixation of the tibial prosthesis, the defect bone graft site is completely covered under the prosthesis. Results All patients were followed up 3 month to 2 years with the average of 2 years, the HSS knee score increased from preoperative 36.7（31 to 54） to postoperative 84.7（76 to 94）.Bone absorption of the autologous bone graft or loosening of the prostheses were not found in cases at final follow-up.Conclusion The short-term outcome of autologous bone graft to repair tibial plateau bone defects in total knee arthroplasty is satisfied.