Department of Orthopaedic Surgery, Niigata Central Hospital, Niigata, Japan.
J Arthroplasty. 2012 Mar;27(3):437-444.e1. doi: 10.1016/j.arth.2011.06.003. Epub 2011 Aug 9.
Superolateral acetabular bone defect is a serious challenge in uncemented total hip arthroplasty for acetabular dysplasia. We report a bulk bone autografting technique without decortication of the acetabulum and femoral head contact surfaces in 22 joints. Mean follow-up time was 8.3 years, and survival rates were 100% for loosening and revision end points. The preoperative Japanese orthopedic association hip score increased from 49.5 to 94.0. Although trabecular bridging and graft remodeling occurred in all cases, complete trabecular reorientation was observed in only 15 joints. Eccentric polyethylene wear was observed in 8 of 22 joints, and osteolysis, in 1 joint. Our technique is easy to perform, and midterm results were favorable; thus, we conclude that it may be an effective option for bulk bone autografting.
髋臼上方骨缺损是髋臼发育不良行非骨水泥全髋关节置换术的严重挑战。我们报告了一种不进行髋臼和股骨头接触面皮质化的大块骨自体移植技术，共治疗了 22 个关节。平均随访时间为 8.3 年，在松动和翻修终点，松动和翻修的累积生存率均为 100%。术前日本矫形协会髋关节评分由 49.5 分提高至 94.0 分。尽管所有病例均出现了小梁桥接和移植物重塑，但仅 15 个关节观察到完全的小梁重新定向。22 个关节中有 8 个存在偏心聚乙烯磨损，1 个关节存在骨溶解。我们的技术易于操作，中期结果良好；因此，我们认为这可能是大块骨自体移植的有效选择。
