膜诱导下髋臼磨钻取骨植骨治疗大段骨缺损患者术后骨吸收发生率及影响因素分析

Influencing factors analysis on resorption rate of bone graft harvested using the acetabular reamer after membrane induced technique for treatment of large bone defects

目的探讨膜诱导下髋臼磨钻取骨植骨治疗大段骨缺损患者术后骨吸收的发生率及影响因素。方法选取自2012年6月至2016年8月收治的采用膜诱导下髋臼磨钻取骨植骨治疗的31例大段骨缺损患者为研究对象,随访9个月以上。观察术后植骨区域骨吸收情况,分析性别、吸烟史、饮酒史、缺损原因、缺损部位及取骨来源等因素对植骨吸收的影响。结果膜诱导后髋臼磨钻取骨植骨治疗大段骨缺损,植骨吸收率为16.1%(5/31)。植骨吸收与骨愈合患者的性别、吸烟史、饮酒史、骨缺损原因、缺损部位及取骨来源比较,差异均无统计学意义(P>0.05)。结论膜诱导治疗大段骨缺损,髋臼磨钻取骨植骨术后,骨吸收的原因及影响因素尚不明确,但应避免在关节囊不完整的关节附近及诱导膜活性较差的情况下采用这种植骨方式,减少植骨吸收的风险。

Objective To investigate the influencing factors analysis on resorption rate of bone graft harvested using the acetabular reamer after membrane induced technique for treatment of large bone defects.Methods A retrospective study was performed on 31 cases of patients with large bone defects who underwent bone graft harvested using the acetabular reamer after membrane induced technique from June 2012 to August 2016.Follow-up was more than 9 months.The bone resorption in the bone grafting area after surgery was observed,and the effects of gender,smoking history,drinking history,defect cause,defect site and bone source on the bone resorption were analyzed.Results After membrane induction,acetabular grinding and drilling for bone grafting was used to treat large bone defects,and the bone graft absorption rate was 16.1%(5/31).There were no statistically significant differences in gender,smoking history,drinking history,bone defect cause,defect site and length,and bone source of the patients with bone graft resorption and bone healing(P>0.05).Conclusion The reasons and influencing factors of bone resorption after bone grafting with bone mud obtained by acetabular grinding and drilling are still not clear.It should be avoided to use this bone grafting method in the vicinity of the joint with incomplete joint capsule and in the case of poor activity of the induced membrane to reduce the risk of bone graft resorption.