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翻修伴骨移植物撞击和 Kerboull 交叉钢板治疗髋臼大骨缺损。

Revision with impacted bone allografts and the Kerboull cross plate for massive bone defect of the acetabulum.

机构信息

Department of Orthopaedic Surgery, Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan.

出版信息

J Arthroplasty. 2010 Jun;25(4):594-9. doi: 10.1016/j.arth.2009.04.003. Epub 2009 Jun 2.

Abstract

We retrospectively reviewed 31 hips with massive bone defect because of aseptic loosening of the acetabulum treated with impacted bone allografts with the Kerboull-type acetabular device. Mean age at surgery was 67.9 years, and mean duration of follow-up was 6.3 years. Thickness of the bone graft was evaluated by postoperative radiography. Seven hips showed radiological failure associated with 6 breakages of the device, and 24 hips showed stability on follow-up radiographs. Of the 13 hips showing a bone graft thickness of greater than 20 mm on follow-up radiographs, 7 were classified as failure group. If an acetabular reinforcement device with a bone graft of more than 20 mm thickness is necessary, then a structural allograft should be considered in the weight-bearing area of the support ring in addition to the morselized bone graft.

摘要

我们回顾性分析了 31 例因髋臼假体无菌性松动导致大块骨缺损的患者,均采用嵌压异体骨移植联合 Kerboull 型髋臼加强装置治疗。手术时的平均年龄为 67.9 岁,平均随访时间为 6.3 年。术后通过影像学评估植骨厚度。7 例出现影像学失败,与 6 例装置断裂有关,24 例在随访 X 线片上显示稳定。在随访 X 线片上显示植骨厚度大于 20mm 的 13 例髋关节中,7 例被归类为失败组。如果需要髋臼加强装置和大于 20mm 厚度的植骨,那么除了碎骨移植外,还应考虑在支撑环的负重区使用结构性同种异体骨。

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