Kawanabe K, Akiyama H, Onishi E, Nakamura T
Department of Orthopaedic Surgery, Faculty of Medicine Kyoto University, Kyoto, Japan.
J Bone Joint Surg Br. 2007 Jan;89(1):26-31. doi: 10.1302/0301-620X.89B1.18037.
We retrospectively evaluated 42 hips which had undergone acetabular reconstruction using the Kerboull acetabular reinforcement device between September 1994 and December 1998. We used autogenous bone chips from the ilium and ceramic particle morsellised grafts, even in large acetabular bone defects, in the early stages of the study. Thereafter, femoral head allograft was used as bulk graft in patients with large acetabular defects. Ceramic blocks and the patients' contralateral femoral head were also used as bulk graft. The mean follow-up period was 8.7 years (4.3 to 12). Survivorship analysis was performed using radiological failure of the acetabular component, irrespective of whether it was revised, or not, as the end-point. The survival rate of the morsellised graft group (25 hips) and the bulk graft group (17 hips) at ten years was 53% (95% confidence interval (CI) 42.5% to 63.5%) and 82% (95% CI 72.4% to 91.6%), respectively. The mid-term results of revision total hip replacement with the Kerboull device were better when bulk graft was used in any size of bone defect.
我们回顾性评估了1994年9月至1998年12月间使用Kerboull髋臼强化装置进行髋臼重建的42例髋关节。在研究早期,即使是大的髋臼骨缺损,我们也使用来自髂骨的自体骨屑和陶瓷颗粒碎骨移植。此后,对于髋臼大缺损患者,使用股骨头异体骨作为大块移植材料。陶瓷块和患者对侧股骨头也用作大块移植材料。平均随访期为8.7年(4.3至12年)。采用髋臼假体的影像学失败作为终点进行生存分析,无论其是否进行翻修。碎骨移植组(25例髋关节)和大块移植组(17例髋关节)十年生存率分别为53%(95%置信区间(CI)42.5%至63.5%)和82%(95%CI 72.4%至91.6%)。在任何大小的骨缺损中使用大块移植材料时,使用Kerboull装置进行翻修全髋关节置换的中期结果更好。