Department of Orthopaedic Surgery, Faculty of Medicine, Menoufia University, Shebin-El-Kom, Menoufia, Egypt.
J Orthop Surg Res. 2023 Sep 11;18(1):671. doi: 10.1186/s13018-023-04154-0.
Acetabular bone loss is a technical challenge in total hip arthroplasty (THA). This study sought to report the functional and radiological results of acetabular reconstruction using impaction bone grafting (IBG) in patients with acetabular bone deficiency undergoing primary or revision THA.
In this prospective study, full history taking, preoperative clinical and radiological evaluation, and preoperative planning and templating were performed. The Paprosky classification and the American Academy of Orthopaedic Surgeons classification were used to assess the acetabular deficiencies. Clinical outcomes were assessed utilizing the Harris hip score (HHS) and a 4-question satisfaction questionnaire. Graft incorporation was evaluated in the last follow-up X-rays.
This study included 50 patients with a mean age of 46.7 ± 15.3 years. The THA was primary in 14 (28%) patients and revision in 36 (72%) patients. The mean HHS improved significantly from 28.8 ± 24.1 preoperatively to 76.6 ± 6.1, with a mean follow-up period of 23 months. Overall, 88% of patients were very satisfied. Complete radiological graft incorporation to host bone was achieved in 35 (70%) patients, and the remaining patients had partial incorporation. Complete graft incorporation was associated more frequently with primary THA, autografts, cementless cups, decreased defect size, and decreased graft layer thickness.
IBG for acetabular reconstruction in THA can achieve excellent clinical and radiological outcomes with a low complication rate.
Level IV.
髋臼骨缺损是全髋关节置换术（THA）的技术挑战。本研究旨在报告在接受初次或翻修 THA 的髋臼骨缺损患者中，使用打压植骨（IBG）进行髋臼重建的功能和影像学结果。
在这项前瞻性研究中，我们进行了详细的病史采集、术前临床和影像学评估以及术前规划和模板制作。使用 Paprosky 分类和美国矫形外科医师学会分类来评估髋臼缺损。使用 Harris 髋关节评分（HHS）和 4 个问题满意度问卷来评估临床结果。在最后一次随访 X 光片上评估移植物的融合情况。
本研究纳入了 50 名平均年龄为 46.7±15.3 岁的患者。初次 THA 为 14 例（28%），翻修 THA 为 36 例（72%）。HHS 平均值从术前的 28.8±24.1 显著改善至 76.6±6.1，平均随访时间为 23 个月。总体而言，88%的患者非常满意。35 例（70%）患者的移植物与宿主骨完全融合，其余患者存在部分融合。完全融合与初次 THA、自体移植物、非骨水泥杯、缺损尺寸减小和移植物层厚度减小有关。
在 THA 中，使用 IBG 进行髋臼重建可以获得良好的临床和影像学结果，并发症发生率低。
IV 级。
