McAllister C M, Borden L S
Washington Sports Medicine and Orthopaedic Associates, Kirkland, WA.
Semin Arthroplasty. 1993 Apr;4(2):80-6.
Acetabular deficiencies seen in revision hip arthroplasty require special attention. Custom components, space-filling cement, relocation of the hip center higher on ilium, and resection arthroplasties have all been used. Allograft reconstruction of acetabular defects has many attractive features, but methods of fixation, long-term success rates, and problems of graft resorption and implant loosening present significant questions. This article presents a classification system for acetabular defects and a surgical technique for correcting them. The results of 218 cementless acetabular reconstructions are reviewed and show the importance of the acetabular rim. When the rim is intact, 97% of reconstructions will remain stable, and 78% of allografts used will consolidate. When the acetabular rim is deficient, special techniques using bulk allograft and internal fixation must be used in order to avoid long-term graft resorption and implant loosening.
翻修髋关节置换术中出现的髋臼缺损需要特别关注。定制假体、骨水泥填充、将髋关节中心向髂骨更高位置重新定位以及切除关节成形术都曾被采用。同种异体骨重建髋臼缺损有许多吸引人的特点，但固定方法、长期成功率以及移植物吸收和植入物松动问题都存在重大疑问。本文介绍了一种髋臼缺损的分类系统以及纠正这些缺损的手术技术。回顾了218例非骨水泥髋臼重建的结果，显示了髋臼边缘的重要性。当髋臼边缘完整时，97%的重建将保持稳定，使用的同种异体骨中有78%会愈合。当髋臼边缘缺损时，必须采用使用大块同种异体骨和内固定的特殊技术，以避免长期的移植物吸收和植入物松动。
