Crowe Ⅲ型髋关节发育不良人工髋关节置换术中自体股骨头结构植骨重建髋臼缺损的疗效分析

Analysis of the Effect of Autogenous Femoral Head Structure Bone Grafting in Reconstruction of Acetabular Defect in Crowe TypeⅢHip Dysplasia Artificial Hip Arthroplasty

目的讨论CroweⅢ型髋关节发育不良人工髋关节置换术中采取自体股骨头结构植骨重建髋臼缺损的临床应用价值。方法选取2018年2月—2019年7月,在该院实施人工髋关节置换术治疗的CroweⅢ型髋关节发育不良患者120例作为研究对象,术中予以患者自体股骨头结构植骨重建髋臼缺损处理,收集患者的临床诊治资料并对相关资料展开回顾性的整合分析。结果将患者治疗后的资料与治疗前对比,治疗前髋关节的评分为(41.20±7.33)分,相比于治疗后(89.92±7.94)分,治疗后患者的髋关节评分明显提升,差异有统计学意义(t=49.389,P<0.001)。术后未发生不良反应。术后12个月后随访的X线检查结果显示,自体植入骨块均显示愈合;X线检查术前单侧患者双下肢不等长为(1.45±0.31)cm,术后12个月单侧患者双下肢不等长为(0.91±0.12)cm,数据对比,差异有统计学意义(t=17.795,P<0.001),术后患者的髋关节评分与术前相比,差异有统计学意义(P<0.05)。结论CroweⅢ型髋关节发育不良人工髋关节置换术中采取自体股骨头结构植骨重建髋臼缺损的临床应用价值较高,有利于增强髋臼假体的稳定性,最大限度提升骨量,临床治疗效果显著。

Objective To discuss the clinical application value of autogenous femoral head structure bone grafting to reconstruct acetabular defects in Crowe typeⅢhip dysplasia.Methods From February 2018 to July 2019,120 patients with Crowe typeⅢhip dysplasia who underwent artificial hip replacement in our hospital were selected as the research sample,and all patients were selected during the artificial hip replacement.In the artificial hip replacement surgery,all the selected patients were treated with autogenous femoral head bone grafting to reconstruct the acetabular defect,and the clinical diagnosis and treatment data of the patients were collected and the relevant data was retrospectively analyzed.Results Compared the data of patients after treatment with that before treatment,the hip score of patients before treatment was(41.20±7.33)points,compared with that after treatment(89.92±7.94)points,the hip score of patients after treatment was significantly improved,the difference was statistically significant(t=49.389,P<0.001).And there was no adverse reactions occurred after operation.Follow-up X-ray examination 12 months after the operation showed healing of the autografted bone.X-ray examination showed that the unequal length of lower extremity of unilateral patients was(1.45±0.31)cm before surgery,and 12 months after surgery,the unequal length of lower extremity of unilateral patients was(0.91±0.12)cm,the difference was statistically significant(t=17.795,P<0.001).Compared with the preoperative Harris score,the difference was statistically significant(P<0.05).Conclusion The clinical application value of autogenous femoral head structure bone graft to reconstruct acetabular defect in Crowe typeⅢhip dysplasia artificial hip replacement surgery is beneficial to enhance the stability of the acetabular prosthesis and maximize the bone mass.The clinical treatment effect is remarkable.