Pitto R P, Di Muria G V, Hohmann D
Orthopädische Klinik der Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany.
Int Orthop. 1998;22(3):161-4. doi: 10.1007/s002640050232.
A substantial loss of bone stock is frequently encountered at revision of a hip replacement. A mix of autologous and homologous bone chips is a biological method of filling the cavities. Reinforcement implants can be used to anchor the new prosthesis and to impact the bone graft, protecting it during healing. The goals of this study were to evaluate the clinical and radiological results after revision of cups with aseptic loosening. Follow-up examination of 81 revisions in 78 patients at 6.5 years (range 3 to 9 years) showed that 93% of the patients were satisfied with their results. One patient underwent a further revision because of recurrent dislocation of the femoral head, and one had a superficial infection. All the grafts were fused at 3 months after the operation. The bone stock had increased in every case, but 6 of them show some degree of graft resorption. No implant showed impending signs of loosening. These results were encouraging. The reinforcement implants allow sufficient primary fixation and secondary stability can be achieved with the impaction grafting. Careful preoperative evaluation and assessment at operation is important to match bone defects with the grafts and selection of the prosthesis.
髋关节置换翻修时经常会出现大量骨量丢失的情况。自体骨和同种异体骨碎片混合是填充骨腔的一种生物学方法。增强植入物可用于固定新的假体并压紧骨移植材料，在愈合过程中起到保护作用。本研究的目的是评估无菌性松动髋臼翻修术后的临床和影像学结果。对78例患者的81次翻修进行了6.5年（范围3至9年）的随访检查，结果显示93%的患者对结果满意。1例患者因股骨头反复脱位接受了再次翻修，1例发生了浅表感染。所有移植材料在术后3个月均已融合。每例患者的骨量均有增加，但其中6例出现了一定程度的移植材料吸收。没有植入物显示出即将松动的迹象。这些结果令人鼓舞。增强植入物可实现充分的初始固定，通过压紧植骨可实现二期稳定性。术前仔细评估和术中评估对于使骨缺损与移植材料相匹配以及假体的选择非常重要。
