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骨库移植物在翻修全髋关节置换术中的应用:转诊中心的患者特征

Use of Bone Bank Grafts in Revision Total Hip Arthroplasty: Patient Characteristics at a Referral Center.

作者信息

Gontijo Thiago de Carvalho, Xavier Luiz Octávio Pereira, Morais Lucas Carneiro, Silva Gustavo Waldolato, Polese Janaíne Cunha, da Silva Raquel Bandeira, Leopoldino Amanda Aparecida Oliveira

机构信息

Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte 30150-270, Brazil.

Hospital Universitário Ciências Médicas de Minas Gerais, Belo Horizonte 30150-270, Brazil.

出版信息

Medicina (Kaunas). 2025 Jul 10;61(7):1246. doi: 10.3390/medicina61071246.

Abstract

: To characterize the epidemiological profile of patients undergoing revision total hip arthroplasty (THA) using bone allografts from a tissue bank, and to identify clinical and surgical factors associated with the selection of graft type in cases of severe periprosthetic bone loss. : This observational, cross-sectional study involved a retrospective review of medical records from a specialized referral center, including revision THA procedures performed between 2013 and 2019. Data were collected on 36 variables covering demographic details (age, sex), surgical history of both hips, comorbidities, medication use, perioperative complications, hospitalization, surgical technique, and characteristics of the bone grafts used. Patients were grouped based on the type of allograft received-structured or morselized (impacted)-and comparative analyses were performed. : A total of 67 revision THA cases were evaluated, with a mean patient age of 63.2 years. Nearly half (47.8%) had no prior hip revision. The average number of previous procedures per patient was 1.73, and the mean interval from primary THA to revision was 178.4 months. Morselized bone allografts were used in 66.7% of cases, and structured allografts in 33.3%. Patients receiving structured grafts had undergone a significantly higher number of prior surgeries ( = 0.01) and had a longer duration since the initial THA ( = 0.04). : These findings suggest that younger patients undergoing primary total hip arthroplasty may be at increased risk for complex revision procedures involving structured grafts later in life, underscoring the need for long-term monitoring and tailored surgical planning in this population.

摘要

描述使用组织库骨移植进行翻修全髋关节置换术(THA)患者的流行病学特征,并确定严重假体周围骨丢失病例中与移植类型选择相关的临床和手术因素。:这项观察性横断面研究涉及对一家专业转诊中心的病历进行回顾性审查,包括2013年至2019年期间进行的翻修THA手术。收集了36个变量的数据,涵盖人口统计学细节(年龄、性别)、双髋手术史、合并症、药物使用、围手术期并发症、住院情况、手术技术以及所用骨移植的特征。根据接受的同种异体骨类型(结构化或碎骨状[嵌压式])对患者进行分组,并进行比较分析。:共评估了67例翻修THA病例,患者平均年龄为63.2岁。近一半(47.8%)患者此前未进行过髋关节翻修。每位患者先前手术的平均次数为1.73次,初次THA至翻修的平均间隔时间为178.4个月。66.7%的病例使用了碎骨状骨移植,33.3%使用了结构化移植。接受结构化移植的患者先前手术次数明显更多( = 0.01),自初次THA以来的时间更长( = 0.04)。:这些发现表明,接受初次全髋关节置换术的年轻患者在日后进行涉及结构化移植的复杂翻修手术时可能风险增加,强调了对该人群进行长期监测和制定个性化手术计划的必要性。

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