Department of Orthopaedic Surgery, Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan.
J Arthroplasty. 2010 Jun;25(4):594-9. doi: 10.1016/j.arth.2009.04.003. Epub 2009 Jun 2.
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.
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。