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在非骨水泥型全髋关节置换翻修术中使用打压松质骨同种异体骨进行髋臼重建。

Acetabular reconstruction by impacted cancellous allografts in cementless total hip arthroplasty revision.

作者信息

Bilgen Omer Faruk, Bilgen Muhammet Sadık, Oncan Tevfik, Danış Mutlu

机构信息

Department of Orthopedics and Traumatology, Uludağ University, Bursa, Turkey.

出版信息

Acta Orthop Traumatol Turc. 2012;46(2):120-5. doi: 10.3944/AOTT.2012.2576.

Abstract

OBJECTIVE

The aim of this study was to evaluate the primary and secondary stability, where 100% or virtually 100% of the uncemented acetabular component contacted with impacted cancellous allografts, focusing especially on the amount of graft used and rim contact.

METHODS

Fifteen cases of acetabular reconstruction using impacted cancellous allografts and cementless porous-coated component in which 100% or virtually 100% of the component contacted only with the allograft were reviewed. Mean follow-up was 97.5 (range: 58 to 130) months after revision. The Harris hip score was used to evaluate clinical results. Radiographic evaluations were done using standard anteroposterior views obtained at the final follow-up.

RESULTS

Two patients underwent re-revision. The mean Harris hip score of the remaining 13 patients was 88.3±11.9 (range: 68 to 100) at the final follow-up. Early postoperative radiographs showed mean angle of inclination of 45° (range: 30° to 55°). There was a mean migration of 6.2±7.8 (range: 0 to 29) mm and the migration amount did not differ according to rim contact (p=0.054). There was no correlation between migration and amount of graft used (p>0.05). There was a significant correlation between migration and follow-up time (p<0.01).

CONCLUSION

Our results imply that 50% host bone contact is not absolutely necessary to form a stable construct while restoring the centre of hip rotation.

摘要

目的

本研究旨在评估初次稳定性和二次稳定性,其中非骨水泥髋臼组件100%或几乎100%与打压植入的松质骨同种异体骨接触,尤其关注所用移植物的量和边缘接触情况。

方法

回顾了15例使用打压植入的松质骨同种异体骨和非骨水泥多孔涂层组件进行髋臼重建的病例,这些病例中组件100%或几乎100%仅与同种异体骨接触。翻修术后平均随访时间为97.5(范围:58至130)个月。采用Harris髋关节评分评估临床结果。在最终随访时通过标准前后位X线片进行影像学评估。

结果

2例患者进行了再次翻修。其余13例患者在最终随访时Harris髋关节平均评分为88.3±11.9(范围:68至100)。术后早期X线片显示平均倾斜角度为45°(范围:30°至55°)。平均移位为6.2±7.8(范围:0至29)mm,移位量与边缘接触情况无关(p = 0.054)。移位与所用移植物的量之间无相关性(p>0.05)。移位与随访时间之间存在显著相关性(p<0.01)。

结论

我们的结果表明,在恢复髋关节旋转中心时,50%的宿主骨接触并非形成稳定结构的绝对必要条件。

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