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髋臼重建中辐照同种异体骨移植的中长期结果:随访报告

Mid- to long-term results of irradiated allograft in acetabular reconstruction: a follow-up report.

作者信息

Emms N W, Buckley S C, Stockley I, Hamer A J, Kerry R M

机构信息

St Helens and Knowsley, Teaching Hospitals NHS Trust, Warrington Road, Prescot, Merseyside L35 5DR, UK.

出版信息

J Bone Joint Surg Br. 2009 Nov;91(11):1419-23. doi: 10.1302/0301-620X.91B11.22274.

Abstract

Between 1990 and 2000, 123 hips in 110 patients were reconstructed for aseptic loosening using impaction bone grafting with frozen, irradiated, morsellised femoral heads and cemented acetabular components. This series was reported previously at a mean follow-up of five years. We have extended this follow-up and now describe the outcome of 86 hips in 74 patients at a mean of ten years. There have been 19 revisions, comprising nine for infection, seven for aseptic loosening and three for dislocation. In surviving acetabular reconstructions, union of the graft had occurred in 64 of 67 hips (95.5%). Survival analysis for all indications at ten years was 83.3% (95% confidence interval (CI) 68 to 89) and 71.3% (95% CI 58 to 84) at 15 years. Acetabular reconstruction using irradiated allograft and a cemented acetabular component is an effective method of reconstruction, providing results in the medium- to long-term comparable with those of reported series where non-irradiated freshly-frozen bone was used.

摘要

1990年至2000年期间,对110例患者的123个髋关节进行了翻修,用于治疗无菌性松动,采用了打压植骨技术,植入冷冻、辐照、碎化的股骨头以及骨水泥固定的髋臼假体。该系列病例此前已报道过平均5年的随访结果。我们延长了随访时间,现在报告74例患者86个髋关节平均10年的随访结果。共进行了19次翻修,其中9次是因为感染,7次是因为无菌性松动,3次是因为脱位。在存活的髋臼翻修病例中,67个髋关节中有64个(95.5%)出现了植骨融合。所有适应证的10年生存率分析为83.3%(95%置信区间(CI)68至89),15年生存率为71.3%(95%CI 58至84)。使用辐照同种异体骨和骨水泥固定髋臼假体进行髋臼翻修是一种有效的翻修方法,中长期结果与报道的使用未辐照新鲜冷冻骨的系列病例相当。

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