Pierchon F, Migaud H, Boden B, Pasquier G, Fontaine C, Duquennoy A
Hopital Stéphanie, Strasbourg, France.
Acta Orthop Belg. 1994;60(3):280-9.
We have reviewed, at a mean follow-up of 63.7 months, 36 total hip replacements performed with bulk acetabular autograft. Before surgery all the hips had acetabular insufficiency. Improvement of acetabular coverage was achieved in all cases with the patient's femoral head screwed to the ilium. Only one massive graft resorption was observed, simultaneous to loosening of the socket. Partial graft resorption was observed in 6 cases, and was not correlated with loosening of the socket. In all cases we observed radiographic features consistent with graft incorporation. Periprosthetic ossifications were noted in 13 cases. At follow-up, four sockets were loose, among which were included three Weill threaded rings. The mean functional improvement scores evaluated with the Merle d'Aubigné hip rating were: 4 points for pain, 2.7 points for mobility, and 2.4 points for walking. The authors concluded that femoral head, used as a massive autograft during total hip replacement, was a safe procedure for bone stock reconstruction in case of severe acetabular insufficiency.
我们对平均随访63.7个月的36例采用大块髋臼自体骨移植进行的全髋关节置换术进行了回顾。术前所有髋关节均存在髋臼发育不良。所有病例通过将患者的股骨头拧入骨来实现髋臼覆盖的改善。仅观察到1例大块移植物吸收，同时伴有髋臼杯松动。6例观察到部分移植物吸收，且与髋臼杯松动无关。在所有病例中，我们观察到与移植物融合一致的影像学特征。13例出现假体周围骨化。随访时，4个髋臼杯松动，其中包括3个Weill螺纹环。采用Merle d'Aubigné髋关节评分评估的平均功能改善分数为：疼痛4分，活动度2.7分，行走2.4分。作者得出结论，在全髋关节置换术中使用股骨头作为大块自体骨移植，对于严重髋臼发育不良的病例，是一种安全的骨量重建手术。
