自体骨与同种异体骨植骨治疗人工全髋关节置换术中髋臼骨缺损的效果比较

Efficacy comparison between autogenous bone and allograft bone graft for acetabular bone defects during total hip arthroplasty

目的比较自体骨与同种异体骨植骨治疗人工全髋关节置换术(THA)中髋臼骨缺损的效果。方法选择60例有髋臼缺损的THA术患者,分为自体骨植骨组(A组)30例与同种异体骨植骨组(B组)30例,分别采用相应方法进行植骨。比较两组患者术后疼痛视觉模拟量表(VAS)评分、髋关节Harris评分、植骨愈合时间、植骨愈合评分及术后并发症发生情况。结果两组患者髋臼骨愈合时间、植骨愈合评分及植骨失败率比较,差异均无统计学意义(均P>0.05),而B组患者术后并发症发生率高于A组(P<0.05)。两组患者的VAS及髋关节Harris评分比较,差异均无统计学意义(均P>0.05),两组的VAS及髋关节Harris评分均有随时间变化的趋势(均P<0.05),分组与时间均无交互效应(均P>0.05)。结论自体骨与同种异体骨植骨治疗髋关节置换术中髋臼缺损均能获得满意结果,且疗效相似,但自体骨植骨术后并发症发生率较低。

Objective To compare the efficacy between autogenous bone and allograft bone graft for acetabular bone defects during artificial total hip arthroplasty(THA).Methods Sixty patients with acetabular defects undergoing THA were divided into 30 cases of autogenous bone graft(group A)and 30 cases of allograft bone graft(group B),and received corresponding procedures respectively for bone graft.The postoperative Visual Analogue Scale(VAS)score,Harris score of hip joint,bone healing time,bone healing score,and incidence of postoperative complications were compared between the two groups.Results There was no significant difference in the acetabular bone healing time,bone healing score or incidence rate of bone graft failure between the two groups(all P>0.05),while the incidence rate of postoperative complications in group B was higher than that in group A(P<0.05).There was no significant difference in VAS score or hip Harris score between the two groups(all P>0.05),VAS score and hip Harris score changed over time in the two groups(all P<0.05),and no interaction effects were found between group and time(all P>0.05).Conclusion Both autogenous bone and allograft bone graft achieve satisfactory results for acetabular defects during hip arthroplasty,having similar efficacy,but the autogenous bone graft obtains a lower incidence rate of postoperative complications.