自体骨打压植骨在生物型人工髋关节初次置换术中的应用效果

Application and Efficacy of Autologous Bone Grafting with Compression in Primary Biologic Hip Arthroplasty

目的探讨生物型人工髋关节初次置换术联合自体骨打压植骨术的临床价值。方法回顾性分析2021年1月到2024年1月到遵义市第一人民医院就诊的80例行生物型人工髋关节初次置换术的病历,根据是否联合自体骨打压植骨术,分为观察组(联合自体骨打压植骨术)和对照组(不联合自体骨打压植骨术),每组各40例。比较两组患者髋关节功能、疼痛程度、神经功能情况以及假体松动情况。结果治疗前,两组患者髋关节功能、疼痛程度,以及神经特异性蛋白S-100B、神经元特异性烯醇化酶(Neuron Specific Enolase,NSE)水平均无显著差异(P>0.05)。治疗后,两组患者髋关节功能、疼痛程度、神经特异性蛋白均得到改善(P<0.05);且观察组Harris髋关节评分(Harris Hip Score,HHS)高于对照组(P<0.001),视觉模拟评分(Visual Analogue Scale,VAS)低于对照组(P<0.001);观察组神经特异性蛋白S-100B、NSE水平均低于对照组(P<0.05)。术后,观察组中无患者出现假体松动(假体松动发生率为0.00%),显著低于对照组中5例患者出现假体松动(假体松动发生率为12.50%),差异有统计学意义(P<0.05)。结论在生物型人工髋关节初次置换术中联合自体骨打压植骨术,有利于髋关节功能和神经功能的恢复,改善患者的疼痛,降低假体松动的发生率。

Objective To assess the clinical value of combining primary total hip arthroplasty with autologous bone impaction grafting.Methods A retrospective analysis was conducted on 80 cases of primary total hip arthroplasty treated at Zunyi First People's Hospital between January 2021 and January 2024.The patients were divided into two groups based on whether autologous bone impaction grafting was performed:the observation group(with autologous bone impaction grafting,n=40)and the control group(without autologous bone impaction grafting,n=40).Hip joint function,pain levels,neurological function,and prosthesis loosening were compared between the two groups.Results Prior to treatment,there were no significant differences between the two groups in terms of hip joint function,pain levels,or the levels of nerve-specific proteins S-100B and NSE(P>0.05).After treatment,improvements were observed in hip joint function,pain levels,and nerve-specific protein levels in both groups(P<0.05).The observation group had significantly higher Harris scores(P<0.001)and lower VAS scores(P<0.001)compared to the control group.Additionally,the observation group exhibited lower levels of S-100B and NSE proteins compared to the control group(P<0.05).Postoperatively,no patients in the observation group experienced prosthesis loosening(0.00%incidence),which was significantly lower than the five cases(12.50%incidence)of prosthesis loosening in the control group(P<0.05).Conclusion Combining autologous bone impaction grafting with primary total hip arthroplasty is beneficial for the recovery of hip joint function and neurological function,alleviates pain,and reduces the incidence of prosthesis loosening.