Caltran Maurice, Savornin Claude, Le Couteur Patrick, Jouan Paul, Deroche Philippe, Vinceneux Jean-François, Barnouin Laurence
Clinique du Val Fleuri, Rue de l'Heritan, Rue de l'Heritan, 71000 , Macon, France.
Hôpital d'instruction des Armées Bégin, 68 avenue de Paris, 94160, Saint Mandé, France.
Eur J Orthop Surg Traumatol. 2002 Dec;12(4):186-91. doi: 10.1007/s00590-002-0051-4. Epub 2002 Dec 17.
Acetabular loosenings with severe bone loss require a large amount of graft material to fill the defect. Although all donors are systematically subjected to serologic screening, bone allografts that are chemically processed, freeze-dried, and radiosterilized ensure a higher level of microbiological safety than radiosterilised deep-frozen allografts. The bone allograft used in this study meets this requirement. Therefore, it was both interesting and important to evaluate its outcome in revision acetabuloplasty. This phase II multi-centre study involves 44 revision total hip replacements (35 evaluable) in patients with acetabular bone defects who received allografts obtained from femoral heads harvested from living donors. The results obtained at 40 months follow-up confirmed that reconstructions using a small amount of graft material have a satisfactory outcome. Where an allograft is used in association with an acetabular ring, good primary stability is provided by the ring and secondary stability is ensured by graft incorporation (which, in our study, has often shown to be enhanced by the use of bone cement). The advantages of this type of bone allograft are its greater ease of use and storage at room temperature.
伴有严重骨量丢失的髋臼松动需要大量移植材料来填充缺损。尽管所有供体都经过了系统的血清学筛查,但经过化学处理、冻干和辐射灭菌的骨同种异体移植在微生物安全性方面比辐射灭菌的深冻同种异体移植更高。本研究中使用的骨同种异体移植符合这一要求。因此,评估其在髋臼翻修成形术中的结果既有趣又重要。这项II期多中心研究涉及44例髋臼骨缺损患者的翻修全髋关节置换术(35例可评估),这些患者接受了来自活体供体股骨头的同种异体移植。40个月随访结果证实,使用少量移植材料进行的重建效果令人满意。当同种异体移植与髋臼环联合使用时,髋臼环提供良好的初始稳定性,移植骨融合确保继发稳定性(在我们的研究中,使用骨水泥常可增强这种稳定性)。这种类型的骨同种异体移植的优点是使用更方便,且可在室温下储存。