El-Kawy S, Hay D, Drabu K
Joint Replacement Research Unit, East Surrey Hospital Redhill, Surrey - UK.
Hip Int. 2005 Jan-Mar;15(1):46-51. doi: 10.1177/112070000501500107.
We conducted this retrospective study to evaluate the medium- term results of impaction bone allograft technique when used on its own with cemented cups in acetabular revisions associated with massive bone loss.
This study involved 28 hips in 27 patients classified as severe acetabular deficiencies (Paprosky type 3) secondary to aseptic loosening. All were revised with impacted morsellised bone allograft using fresh-frozen and freeze-dried bone together with cemented rim bearing UHMWP (28 mm I.D.) cups and followed for an average of 72 months (range 48 to 91 m). Clinical assessment was based on the Harris Hip Score (HHS). Radiological assessment included measurement of cup migration using image analysis computer software as well as assessment of graft incorporation.
Clinically, HHS improved from pre-operative average of 24.9 to average of 78 at the last follow-up. One hip was revised at 12 months postoperatively due to aseptic loosening. Survivorship for the cup with endpoint revision for any reason was 96.4%. Radio-logically, the average of superior migration was 1.53 mm; average of medial migration was 0.59 mm. 92.8% of hips showed radiographic evidence of graft incorporation. Cup survival rate with aseptic loosening as endpoint was 92.85%.
The technique of impaction bone grafting using morsellised fresh frozen bone allograft appears to be a valuable biological option in such patients, with encouraging results, but further follow-up is required to establish the longer term outcome of these reconstructions. (Hip International 2005; 15: 46-51).
我们开展这项回顾性研究，以评估在伴有大量骨质流失的髋臼翻修术中，单纯使用打压植骨技术并结合骨水泥杯的中期结果。
本研究纳入了27例患者的28个髋关节，这些患者被归类为继发于无菌性松动的严重髋臼缺损（Paprosky 3型）。所有患者均采用新鲜冷冻骨和冻干骨混合的颗粒状异体骨打压植骨，并使用带骨水泥边缘的超高分子量聚乙烯（内径28 mm）杯进行翻修，平均随访72个月（范围48至91个月）。临床评估基于Harris髋关节评分（HHS）。影像学评估包括使用图像分析计算机软件测量髋臼杯移位，以及评估植骨融合情况。
临床方面，HHS从术前平均24.9分提高到最后一次随访时的平均78分。1例髋关节在术后12个月因无菌性松动进行了翻修。因任何原因进行翻修作为终点的髋臼杯生存率为96.4%。影像学方面，上移平均为1.53 mm；内移平均为0.59 mm。92.8%的髋关节有影像学证据显示植骨融合。以无菌性松动为终点的髋臼杯生存率为92.85%。
对于此类患者，使用颗粒状新鲜冷冻异体骨进行打压植骨技术似乎是一种有价值的生物学选择，结果令人鼓舞，但需要进一步随访以确定这些重建的长期结果。（《国际髋关节杂志》2005年；15：46 - 51）
