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[髋臼凸度——全髋关节置换术的一项特殊补充]

[Acetabular convexity--a specific addition to total endoprosthetic hip replacement].

作者信息

Gleissner F, Wessinghage D, Fitzek J G

机构信息

I. Orthopädischen Klinik des BRK-Rheumazentrums Bad Abbach/Regensburg.

出版信息

Z Orthop Ihre Grenzgeb. 1991 Mar-Apr;129(2):188-93. doi: 10.1055/s-2008-1040181.

DOI:10.1055/s-2008-1040181
PMID:1829302
Abstract

Between 1. 1. 1977 and 30. 6. 1988, 1470 total hip prostheses were implanted at the 1st Orthopedic Clinic in Bad Abbach/Regensburg. In 101 cases (82 patients, average age 54.8 years) the acetabular convexity was built up at the same time. This is considered indicated if the acetabulum is too shallow and thus provides insufficient lateral or dorsolateral countersupport. The main area of indication is dysplasia-coxarthrosis and congenital dislocation of the hip, destructive coxitis in chronic polyarthritis or juvenile chronic arthritis, and loosened prostheses. The material used for building up the convexity is a block of corticocancellous bone, which is fixed ventrolaterally to dorsolaterally to the ilium by osteosynthesis. Autologous material was used in 88 cases and homologous material in 13. Sixty-one patients with a total of 77 built-up convexities were followed up. In 92.2% a bony bridge between the corticocancellous block and the rising branch of the ilium was fund. The method described is a valuable addition to replacements in case of extreme hip joint changes and replacement operations. In the authors' opinion it has considerable advantages over supporting shells and similar materials.

摘要

1977年1月1日至1988年6月30日期间,在巴特阿巴赫/雷根斯堡的第一骨科诊所共植入了1470个全髋关节假体。其中101例(82名患者,平均年龄54.8岁)同时进行了髋臼凸度重建。如果髋臼过浅,从而提供的外侧或背外侧反支撑不足,则认为有必要进行此项手术。主要适应症包括发育不良性髋关节病和先天性髋关节脱位、慢性多关节炎或青少年慢性关节炎中的破坏性髋关节炎以及假体松动。用于重建凸度的材料是一块皮质松质骨,通过骨合成从腹外侧向背外侧固定在髂骨上。88例使用自体材料,13例使用同种异体材料。对61例共77个重建凸度的患者进行了随访。发现92.2%的患者在皮质松质骨块与髂骨升支之间形成了骨桥。所描述的方法是极端髋关节变化和置换手术中置换术的一项有价值的补充。在作者看来,它比支撑壳和类似材料具有相当大的优势。

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引用本文的文献

1
Femoral head bone grafting for reconstruction of the acetabular wall in dysplastic hip replacement.股骨头植骨用于发育性髋关节置换术中髋臼壁的重建。
Arch Orthop Trauma Surg. 1995;114(5):269-73. doi: 10.1007/BF00452085.