Dua Aman, Kiran Krishna, Malhotra Rajesh, Bhan Surya
Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
Hip Int. 2010 Apr-Jun;20(2):143-9. doi: 10.1177/112070001002000203.
The success of total hip arthroplasty has led to a move toward operating on a wider and younger population. All implants have a finite useful life, and bone loss is associated with all major causes of failure. The use bone allograft, either morselized or structural has the aim of reconstituting the bone stock. We retrospectively reviewed the clinical and radiological results of 72 acetabular reconstructions both primary and revision, done at our institute between May 1999 and October 2004 with a minimum follow-up of one year. The Harris Hip Score (HHS) was calculated and follow-up radiographs were evaluated for graft incorporation; evidence of loosening and migration. Preoperatively 28 acetabular defects were type III (AAOS), 18 were type II, 16 were type I and 10 were type IV. 60 reconstructions were done using cementless acetabular prostheses, and the remaining twelve had cemented implants. Patients were followed up for an average of 30.69 months (range 12 - 64 months). The mean preoperative HHS was 36.13 points which improved to a mean of 81.6 points (range 61 to 91) at final follow-up. None of the patients required reoperation. Dislocation was the commonest complication (8 hips). Short and medium term results were encouraging with the use of this technique.
全髋关节置换术的成功促使手术对象向更广泛、更年轻的人群发展。所有植入物都有有限的使用寿命，而骨量流失与所有主要的失败原因相关。使用碎骨或结构性同种异体骨的目的是重建骨量。我们回顾性分析了1999年5月至2004年10月在我院进行的72例髋臼重建手术（包括初次手术和翻修手术）的临床和放射学结果，随访时间至少为一年。计算Harris髋关节评分（HHS），并对随访X线片进行评估，以观察移植物融合情况、松动和移位迹象。术前，28例髋臼缺损为III型（美国矫形外科医师学会分类），18例为II型，16例为I型，10例为IV型。60例重建手术使用了非骨水泥髋臼假体，其余12例使用了骨水泥植入物。患者平均随访30.69个月（范围为12至64个月）。术前HHS平均为36.13分，末次随访时平均提高到81.6分（范围为61至91分）。无一例患者需要再次手术。脱位是最常见的并发症（8例）。使用该技术的短期和中期结果令人鼓舞。
