Arzeno Alexander, Wang Tim, Huddleston James I
Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Arthroplast Today. 2018 Jan 12;4(2):162-168. doi: 10.1016/j.artd.2017.12.004. eCollection 2018 Jun.
Revision hip arthroplasty in the setting of periacetabular bone loss presents a significant challenge, as options for restoring bone loss are limited. Recombinant human bone morphogenetic protein-2 may offer a solution by promoting bone growth to restore bone stock before implant reimplantation. Here we present a case of a patient with a periprosthetic acetabulum fracture, resulting in pelvic discontinuity as the result of significant periacetabular bone loss. Using a staged approach, periacetabular bone stock was nearly entirely reconstituted using recombinant BMPs and allograft, which resulted in stable fixation, but with abundant heterotopic bone formation. Recombinant BMP-2 offers a useful tool for restoring bone stock in complex hip arthroplasty revision cases with periacetabular bone loss; however, caution must be used as overabundant bone growth as heterotopic ossification may result.
在髋臼周围骨质流失的情况下进行髋关节翻修置换术面临重大挑战，因为恢复骨质流失的选择有限。重组人骨形态发生蛋白-2可能提供一种解决方案，即在重新植入假体之前通过促进骨生长来恢复骨量。在此，我们报告一例患者，其假体周围髋臼骨折，由于髋臼周围严重骨质流失导致骨盆连续性中断。采用分期手术方法，使用重组骨形态发生蛋白和同种异体骨几乎完全重建了髋臼周围骨量，这导致了稳定的固定，但出现了大量异位骨形成。重组骨形态发生蛋白-2为髋臼周围骨质流失的复杂髋关节翻修置换病例恢复骨量提供了一种有用的工具；然而，必须谨慎使用，因为过度的骨生长可能导致异位骨化。
