Badhe N P, Howard P W
Derbyshire Royal Infirmary, Derby, United Kingdom.
J Arthroplasty. 2000 Jan;15(1):63-8. doi: 10.1016/s0883-5403(00)91207-5.
We evaluated the use of a stemmed acetabular cup with morcellized allograft in the treatment of severe acetabular deficiency requiring reconstruction at arthroplasty. There were 29 hips, of which 22 were revision operations (18 aseptic, 4 postinfective) and 7 were complex primary hip replacements. All patients had severe acetabular deficiency as classified by the American Academy of Orthopaedic Surgeons: type IIB, 3; type IIIa, 18; type IIIB, 8. The patients had a mean follow-up of 46 months (range, 14-74 months). The hip center of rotation improved from a mean preoperative, side-to-side difference of 11.5 mm to 2.5 mm postoperatively (P < .001 ). The medial bone stock improved from a mean preoperative value of 1.5 mm to 11 mm postoperatively (P < .001). The Harris Hip Score improved from a mean preoperative score of 42 points to a postoperative score of 84 points (P < .001 ). There was 1 case of failure resulting from sepsis. The early results with this method of reconstruction of severe acetabular deficiency show encouraging restoration of bone stock, with no cases of aseptic loosening until the last follow-up.
我们评估了带柄髋臼杯联合异体骨碎骨片在治疗人工关节置换术中需要重建的严重髋臼缺损方面的应用。共有29例髋关节，其中22例为翻修手术（18例无菌性，4例感染后），7例为复杂初次髋关节置换。所有患者均存在美国矫形外科医师学会分类的严重髋臼缺损：IIB型3例；IIIa型18例；IIIB型8例。患者平均随访46个月（范围14 - 74个月）。髋关节旋转中心术前平均左右差值为11.5 mm，术后改善至2.5 mm（P < .001）。内侧骨量术前平均为1.5 mm，术后改善至11 mm（P < .001）。Harris髋关节评分术前平均为42分，术后提高至84分（P < .001）。有1例因败血症导致失败。这种严重髋臼缺损重建方法的早期结果显示骨量恢复令人鼓舞，直至最后一次随访均无无菌性松动病例。
