人工全髋关节翻修术中髋臼骨缺损的分类和重建

Classification and reconstruction of acetabular defects in revision total hip arthroplasty

人工全髋关节置换术作为一项逐渐成熟的技术,已经被越来越多的骨科医师所熟知和开展,但随之也使髋关节翻修术患者增多。翻修的原因主要包括假体的无菌性松动、不稳、周围骨折、内衬磨损等,而髋臼骨缺损和髋臼假体的选择一直困扰着广大医师。本文总结了人工全髋关节翻修术中髋臼骨缺损的分类和重建,比较各种分类法的优缺点,在此基础上有多种植骨方式及髋臼假体的选择来重建髋臼,阐述了植骨的材料来源、植骨方式、复杂髋臼骨缺损的重建以及假体固定方式的选择,为临床医生处理各种髋臼骨缺损提供依据,以期更精准地指导临床个体化治疗。

As a mature technology gradually,the total hip arthroplasty has been known and conducted by more and more orthopedic surgeons. However,it also increased the number of hip revisions. The reasons for revision of hip mainly include：unstable,infection,aseptic loosening prosthesis,prosthesis peripheral fracture,liner wear and so on,and the acetabulum bone defect and the choice of acetabular prosthesis have been perplexing surgeons. In this paper,we summarise classification and reconstruction of acetabulum bone defect in hip revision oprations,compare the advantages and disadvantages of all kinds of classification,on this basis can have more than one bone grafting mode and the choice of the acetabulum prosthesis for reconstruction of acetabulum,then expound the ways of material sources,bone grafting modes and complex acetabulum bone defect reconstruction as well as the choice of the ways of fixed prosthesis,providing the basis for clinical doctors to deal with all kinds of acetabulum bone defect and the choice of the acetabulum prosthesis,guiding patient specific therapy more precisely.