Jasty M, Harris W H
Orthopaedic Biomechanics Laboratory, Massachusetts General Hospital and Harvard Medical School, Boston 02114.
J Bone Joint Surg Br. 1990 Jan;72(1):63-7. doi: 10.1302/0301-620X.72B1.2298796.
We evaluated 38 hip reconstructions in 36 patients at a mean follow-up of 5.9 years (range 4 to 9.1) after femoral head allografts had been used to augment severely deficient acetabular bone stock. The patients were all relatively young and had many previous operations. Their pre-operative Harris hip rating averaged 46 points (range 18 to 73). All the allografts united and there were no infections. However, 12 acetabular components (32%) became loose; six of these had needed revision using the healed allograft, and two hips had required resection arthroplasty. The 30 surviving hips had a mean Harris hip score of 82 points. Some radiographic evidence of graft resorption was seen in 23 hips, though this was mild in 17. The extent of cover provided by the allograft and the severity of graft resorption both correlated with acetabular loosening. Although structural allografts had allowed successful hip reconstructions in many of these patients with major bone loss, the failure rate had increased from zero at four years to 32% at six years; clearly they provide only a short-term solution.
我们对36例患者的38次髋关节重建进行了评估，这些患者在使用股骨头异体骨移植来增加严重缺损的髋臼骨量后，平均随访5.9年（范围4至9.1年）。患者均相对年轻，且之前接受过多次手术。他们术前的Harris髋关节评分平均为46分（范围18至73分）。所有异体骨均已愈合，且无感染发生。然而，12个髋臼假体（32%）出现松动；其中6个需要使用愈合的异体骨进行翻修，2例髋关节需要行切除关节成形术。30个存活髋关节的Harris髋关节平均评分为82分。23例髋关节出现了一些移植骨吸收的影像学证据，不过其中17例较轻。异体骨提供的覆盖范围和移植骨吸收的严重程度均与髋臼松动相关。尽管结构性异体骨使许多这些严重骨缺损患者成功进行了髋关节重建，但失败率从4年时的零增加到6年时的32%；显然，它们仅提供了短期解决方案。
