Bobak P, Wroblewski B M, Siney P D, Fleming P A, Hall R
The John Charnley Research Institute, Wrightington Hospital, Appley Bridge, Wigan, UK.
J Bone Joint Surg Br. 2000 May;82(4):508-11. doi: 10.1302/0301-620x.82b4.10199.
Between 1983 and 1988 we carried out 45 Charnley low-friction arthroplasties with autografts from the femoral head in 41 patients for developmental dysplasia of the hip. The preoperative radiographs were assessed for the severity of DDH according to the classifications of Crowe et al, Hartofilakidis et al and Sharp. The postoperative and follow-up radiographs were analysed for coverage of the socket by the graft, for loosening and for the outcome of the fixation of the bone graft. Two patients died (two hips) at four and seven years after THR from causes unrelated to the surgery and were excluded from the final radiological analysis. The mean age of the patients at the time of operation was 46 years 3 months. The autograft of the femoral head covered a mean 26% (16 to 35) of the acetabular component. All the grafts united. Some degree of resorption of the bone graft occurred in 27 patients, and always involved the lateral part of the graft, which was beyond the margin of the socket. After a mean follow-up of 11 years there had been no revisions and 38 patients had no pain or only slight discomfort. One socket migrated and four others were fully demarcated. Our findings indicate that the Charnley LFA with an autograft of the femoral head for DDH remains successful at a follow-up of 15 years.
1983年至1988年间，我们对41例发育性髋关节发育不良患者进行了45例Charnley低摩擦人工关节置换术，采用股骨头自体骨移植。根据Crowe等人、Hartofilakidis等人和Sharp的分类方法，对术前X线片进行评估，以确定发育性髋关节发育不良的严重程度。对术后及随访X线片进行分析，观察移植骨对髋臼的覆盖情况、有无松动以及骨移植固定的效果。2例患者（2髋）在全髋关节置换术后4年和7年因与手术无关的原因死亡，被排除在最终的影像学分析之外。手术时患者的平均年龄为46岁3个月。股骨头自体骨移植平均覆盖髋臼假体的26%（16%至35%）。所有移植骨均愈合。27例患者出现了一定程度的骨移植吸收，且总是累及移植骨超出髋臼边缘的外侧部分。平均随访11年后，没有进行翻修手术，38例患者无疼痛或仅有轻微不适。1个髋臼发生移位，另外4个髋臼完全分界清晰。我们的研究结果表明，对于发育性髋关节发育不良采用Charnley低摩擦人工关节置换术并进行股骨头自体骨移植，在15年的随访中仍然取得了成功。
