自体骨移植小臼杯全髋关节置换治疗成人髋臼发育不良

Total hip replacement for the treatment of developmental dysplasia of human acetabulum bone using small acetabular components combined with autogenous bone grafting

目的 观察应用自体骨移植小臼杯全髋关节置换术治疗成人髋臼发育不良的临床效果。方法 以应用自体骨移植小臼杯全髋关节置换术治疗的成人髋臼发育不良26例（39髋）为研究对象,所有患者均采用取自体股骨头对髋臼进行结构性植骨重建,安置小臼杯人工全髋关节置换,对比患者术前及术后髋关节功能改善情况,采用Harris评分进行统计学分析,并通过CT分析植骨块的愈合情况。结果 患者术后随访6~24个月,平均13个月。术后随访X线显示假体位置满意,无松动、移位变化。术后3个月CT扫描显示植骨块与骨盆愈合良好,且与假体匹配较好,无骨块吸收及假体松动。末次随访Harris评分（87.5±8.5）分,较术前Harris评分（46.32±5.12）分,治疗后Harris评分显著升高,差异有统计学意义（P〈0.05）。结论 自体股骨头为松质骨,取材方便,容易愈合,采用自体骨移植小臼杯全髋关节置换术治疗成人髋臼发育不良可取得显著的早期疗效。

Objective To observe the clinical effect of total hip replacement using small acetabular components combined with autogenous bone grafting in the treatment of dysplasia of the hip in adult patients. Methods Twenty-six patients （39 hips） who were structural bone reconstruction by total hip replacement using small acetabular components combined with autogenous femoral head were included in this study. Hip joint function was compared before and after treatment. Harris score and CT scans were used to evaluate the effects. Results All of the patients were followed up by 13 months （ranged from 6-24 months）. The X-ray films showed that all prosthesis were located in the favorable position with no looseness and shift change. 3 months after the operation, grafted bone and pelvic matched well with the prosthesis. There was no osteolysis or prosthesis loosening. There was significant difference （P〈0.05） between preoperative Harris score （46.3±5.1 points） and the latest follow-up Harris score （87.5±8.5 points）. Conclusion The autogenous femoral head is a kind of cancellous bone, which is easy to heal. The early efficacy of total hip replacement using small acetabular components combined with autogenous bone grafting in the treatment of developmental dysplasia of the hip in adult patients is satisfactory.