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髋臼假体一体化与植骨在 Crowe Ⅱ型和Ⅲ型髋关节发育不良全髋关节置换术中的应用：一项回顾性病例对照研究。

Integrated Acetabular Prosthesis Versus Bone Grafting in Total Hip Arthroplasty for Crowe Type II and III Hip Dysplasia: A Retrospective Case-Control Study.

机构信息

Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China.

Laboratory of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China.

出版信息

Orthop Surg. 2024 Oct;16(10):2401-2409. doi: 10.1111/os.14143. Epub 2024 Jul 23.

DOI:10.1111/os.14143
PMID:39043609
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11456704/
Abstract

OBJECTIVE: Many methods of acetabular reconstruction with total hip arthroplasty (THA) for Crowe type II and III adult developmental dysplasia of the hip (DDH) acetabular bone defect have been implemented clinically. However, there was no study comparing the results of integrated acetabular prosthesis (IAP) with bone grafting (BG). This study aims to investigate the efficacy of IAP and BG for acetabular reconstruction in Crowe type II and III DDH. METHODS: The clinical data of 45 patients with unilateral Crowe type II and III DDH who underwent THA from January 2020 to January 2023 were retrospectively analyzed. The patients were divided into two groups: 25 patients using 3D-printed IAP (IAP group) and 20 patients using BG (BG group). The operation time and intraoperative blood loss were recorded. The clinical outcomes were assessed by Harris Hip Score (HHS) and full weight-bearing time. The radiological outcomes were evaluated by the radiological examination. Accordingly, intraoperative and postoperative complications were observed as well. The data between the two groups were compared by independent sample t-tests and the Mann-Whitney U rank sum test. RESULTS: There were no significant differences between the two groups in Harris Hip Score (HHS) (preoperative, 6 months postoperative, and the last follow-up), leg length discrepancy (LLD), cup inclination, cup anteversion, vertical center of rotation (V-COR), horizontal center of rotation (H-COR) (p > 0.05). The mean HHS in the IAP group was higher than in the BG group at 1 and 3 months postoperative (p < 0.001). The mean surgical time and blood loss in the IAP group were less than in the BG group (p < 0.001). The mean full weight-bearing time in the IAP group was shorter than in the BG group (p < 0.01). No complications were observed in either group during the follow-up period. CONCLUSION: IAP and BG have similar radiographic outcomes and long-term clinical efficacy in THA for Crowe type II and III DDH, but the IAP technique has higher surgical safety and facilitates the recovery of hip joint function, which is worthy of clinical promotion.

摘要

目的：对于 Crowe Ⅱ型和Ⅲ型成人发育性髋关节发育不良（DDH）髋臼骨缺损，全髋关节置换术（THA）有多种髋臼重建方法。然而，目前还没有研究比较整体髋臼假体（IAP）与植骨（BG）的结果。本研究旨在探讨 IAP 和 BG 治疗 Crowe Ⅱ型和Ⅲ型 DDH 髋臼重建的疗效。

方法：回顾性分析 2020 年 1 月至 2023 年 1 月间 45 例单侧 Crowe Ⅱ型和Ⅲ型 DDH 患者接受 THA 的临床资料。患者分为两组：25 例采用 3D 打印 IAP（IAP 组），20 例采用 BG（BG 组）。记录手术时间和术中失血量。采用 Harris 髋关节评分（HHS）和完全负重时间评估临床疗效。影像学检查评估影像学结果。观察术中及术后并发症。采用独立样本 t 检验和 Mann-Whitney U 秩和检验比较两组数据。

结果：两组患者 Harris 髋关节评分（HHS）（术前、术后 6 个月和末次随访）、下肢长度差异（LLD）、杯倾斜角、杯前倾角、垂直旋转中心（V-COR）、水平旋转中心（H-COR）差异无统计学意义（p>0.05）。IAP 组术后 1 个月和 3 个月 HHS 均高于 BG 组（p<0.001）。IAP 组手术时间和术中出血量均少于 BG 组（p<0.001）。IAP 组完全负重时间短于 BG 组（p<0.01）。两组患者随访期间均未见并发症。

结论：IAP 和 BG 治疗 Crowe Ⅱ型和Ⅲ型 DDH 的髋臼重建具有相似的影像学结果和长期临床疗效，但 IAP 技术具有更高的手术安全性，有利于髋关节功能的恢复，值得临床推广。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d52/11456704/b1ce353fb98b/OS-16-2401-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d52/11456704/530c9a7ca399/OS-16-2401-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d52/11456704/d77145cd9f51/OS-16-2401-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d52/11456704/77ca018b6163/OS-16-2401-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d52/11456704/39806409148e/OS-16-2401-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d52/11456704/b1ce353fb98b/OS-16-2401-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d52/11456704/530c9a7ca399/OS-16-2401-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d52/11456704/d77145cd9f51/OS-16-2401-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d52/11456704/77ca018b6163/OS-16-2401-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d52/11456704/39806409148e/OS-16-2401-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d52/11456704/b1ce353fb98b/OS-16-2401-g005.jpg

相似文献

[1]
Integrated Acetabular Prosthesis Versus Bone Grafting in Total Hip Arthroplasty for Crowe Type II and III Hip Dysplasia: A Retrospective Case-Control Study.

Orthop Surg. 2024-10

[2]
Accuracy and practicability of a patient-specific guide using acetabular superolateral rim during THA in Crowe II/III DDH patients: a retrospective study.

J Orthop Surg Res. 2019-1-14

[3]
Robotic-Assisted Total Hip Arthroplasty in Patients Who Have Developmental Hip Dysplasia.

Surg Technol Int. 2021-7-26

[4]
Medial Protrusio Technique Versus Structural Autologous Bone-Grafting Technique in Total Hip Arthroplasty for Crowe Type II to III Hip Dysplasia.

J Arthroplasty. 2024-1

[5]
Comparison of High Hip Center versus Anatomical Reconstruction Technique in Crowe Types II and III Developmental Dysplasia of the Hip: a Retrospective Clinical Study.

Acta Chir Orthop Traumatol Cech. 2022

[6]
[Short-term effectiveness of structural bone graft and total hip arthroplasty through direct anterior approach in lateral decubitus position for Crowe type and developmental dysplasia of the hip].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022-9-15

[7]
[Biomechanical research progress of common acetabular reconstruction techniques for Crowe type and developmental dysplasia of the hip].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023-3-15

[8]
Minimum 10-Year Survivorship of Uncemented Acetabular Reconstruction With Bulk Femoral Head Autografting in Crowe Type IV Developmental Hip Dysplasia.

J Arthroplasty. 2024-10

[9]
[Application of Mako robot-assisted total hip arthroplasty in developmental dysplasia of the hip].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021-10-15

[10]
Extra-articular Blocking Technique to Resolve Severe Acetabular Bone Defect in Developmental Dysplasia of the Hip.

Orthop Surg. 2023-4

本文引用的文献

[1]
3D-printed porous tantalum artificial bone scaffolds: fabrication, properties, and applications.

Biomed Mater. 2024-5-15

[2]
Guided Bone Regeneration Using a Novel Magnesium Membrane: A Literature Review and a Report of Two Cases in Humans.

J Funct Biomater. 2023-6-1

[3]
Femoral Head Autograft to Manage Acetabular Bone Loss Defects in THA for Crowe III Hips by DAA: Retrospective Study and Surgical Technique.

J Clin Med. 2023-1-17

[4]
Comparing the effect of cup placement between true and false acetabula in total hip arthroplasty in patients with Crowe type 3 dysplastic hip: A randomized clinical trial.

J Res Med Sci. 2022-9-27

[5]
Knee Reconstruction Using 3D-Printed Porous Tantalum Augment in the Treatment of Charcot Joint.

Orthop Surg. 2022-11

[6]
Comparison of High Hip Center versus Anatomical Reconstruction Technique in Crowe Types II and III Developmental Dysplasia of the Hip: a Retrospective Clinical Study.

Acta Chir Orthop Traumatol Cech. 2022

[7]
Anatomic acetabular reconstruction with femoral head autograft for developmental dysplasia of the hip (DDH) with a minimum follow-up of 10 years.

Hip Int. 2023-7

[8]
Three-dimensional-printed titanium implants for severe acetabular bone defects in revision hip arthroplasty: short- and mid-term results.

Int Orthop. 2022-6

[9]
Reconstruction of Paprosky Type III Acetabular Defects by Three-Dimensional Printed Porous Augment: Techniques and Clinical Outcomes of 18 Consecutive Cases.

Orthop Surg. 2022-5

[10]
The Development of Leg Length Difference and Influence on Persistent Dysplasia in Patients with Developmental Dysplasia of the Hip.

Indian J Orthop. 2021-8-30

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