Department of Orthopedic Surgery, Kyoto University, Sakyo, Kyoto, Japan.
J Arthroplasty. 2010 Aug;25(5):716-20. doi: 10.1016/j.arth.2009.05.017. Epub 2009 Jul 4.
We present the long-term results (mean follow-up, 11.8 years; range, 6.3-15.4 years) of cemented total hip arthroplasty with acetabular bulk bone grafting in 147 dysplastic hips using improved surgical techniques. Operations were performed through a direct lateral approach with partial trochanteric osteotomy to avoid nonunion of the greater trochanter. Bioresorbable poly(l-lactide) screws were used for fixation of the acetabular bone grafts to prevent any possible delayed remodeling. Preoperative planning using computer simulation was performed to estimate the optimal size and position of the acetabular component. Analysis predicted rates of survival of the acetabular component of 96% and 91% at 15 years, with revision for aseptic loosening and radiologic loosening as the end points, respectively. Our results indicate excellent long-term clinical and radiographic survivorship of a cemented acetabular component with bulk autograft for acetabular dysplasia.
我们介绍了使用改良手术技术在 147 例髋臼发育不良髋关节中进行骨水泥固定全髋关节置换术的长期结果(平均随访时间为 11.8 年,范围为 6.3-15.4 年)。手术采用直接外侧入路和部分转子切开术,以避免大转子不愈合。生物可吸收聚(L-丙交酯)螺钉用于固定髋臼骨移植物,以防止任何可能的延迟重塑。使用计算机模拟进行术前规划,以估计髋臼部件的最佳尺寸和位置。分析预测髋臼部件的 15 年生存率分别为 96%和 91%,以无菌性松动和影像学松动为终点。我们的结果表明,对于髋臼发育不良,使用骨水泥固定髋臼和大块自体移植物的髋臼部件具有出色的长期临床和影像学存活率。