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使用大块自体股骨头植骨进行髋臼重建的混合全髋关节置换术的14年平均随访结果。

Mean 14-year Outcomes of Hybrid Total Hip Arthroplasty Using Bulk Femoral Head Autografts for Acetabular Reconstruction.

作者信息

Shimamura Masashi, Katayama Naoyuki, Ohura Hisanori

机构信息

Department of Orthopaedic Surgery, Shikoku Medical Center for Children and Adults, Zentsuji-shi, Kagawa, Japan; Hokkaido Orthopaedic Memorial Hospital, Sapporo, Hokkaido, Japan.

Hokkaido Orthopaedic Memorial Hospital, Sapporo, Hokkaido, Japan.

出版信息

J Arthroplasty. 2023 Dec;38(12):2667-2672. doi: 10.1016/j.arth.2023.06.013. Epub 2023 Jun 13.

Abstract

BACKGROUND

We aimed to evaluate the mean 14-year outcomes of hybrid total hip arthroplasty (THA) with cementless acetabular cups using bulk femoral head autografts in acetabular reconstruction and specify the radiological characteristics of cementless acetabular cups using this technique.

METHODS

This retrospective study included 98 patients (123 hips) who underwent hybrid THA with a cementless acetabular cup using bulk femoral head autografts for bone deficiency in acetabular dysplasia and who were followed-up for a mean of 14 years (range, 10 to 19.6). The percentage of bone coverage index (BCI) and cup center-edge (CE) angles were evaluation radiologically of acetabular host bone coverage. The survival rate of the cementless acetabular cup and autograft bone ingrowth were assessed.

RESULTS

The survival rate with all revisions of cementless acetabular cups was 97.1% (95% confidence interval: 91.2 to 99.1). The autograft bone was remodeled or reoriented in all cases except in 2 hips where the bulk femoral head autograft collapsed. Radiological evaluation revealed a mean cup CE angle of -17.8° (range, -52 to -7°) and a BCI of 44.4% (range, 10 to 75.4%).

CONCLUSION

Cementless acetabular cups using bulk femoral head autografts for bone deficiency of the acetabular roof remained stable even if the average BCI was 44.4% and the average cup CE angle was -17.8°. Cementless acetabular cups using these techniques showed good 10-year to 19.6-year outcomes and viabilities of graft bones.

摘要

背景

我们旨在评估采用大块自体股骨头移植进行髋臼重建的混合式全髋关节置换术(THA)14年的平均疗效,并明确使用该技术的非骨水泥髋臼杯的放射学特征。

方法

这项回顾性研究纳入了98例患者(123髋),这些患者接受了采用大块自体股骨头移植的非骨水泥髋臼杯的混合式THA,用于髋臼发育不良骨缺损的治疗,平均随访14年(范围为10至19.6年)。通过放射学评估髋臼宿主骨覆盖的骨覆盖指数(BCI)百分比和髋臼杯中心边缘(CE)角。评估非骨水泥髋臼杯的生存率和自体移植骨的骨长入情况。

结果

所有非骨水泥髋臼杯翻修后的生存率为97.1%(95%置信区间:91.2至99.1)。除2髋大块自体股骨头移植塌陷外,所有病例中的自体移植骨均发生重塑或重新定向。放射学评估显示髋臼杯平均CE角为-17.8°(范围为-52至-7°),BCI为44.4%(范围为10至75.4%)。

结论

即使平均BCI为44.4%,平均髋臼杯CE角为-17.8°,采用大块自体股骨头移植治疗髋臼顶骨缺损的非骨水泥髋臼杯仍保持稳定。使用这些技术的非骨水泥髋臼杯在10至19.6年显示出良好的疗效和移植骨的生存能力。

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