中国组织工程研究2017，Vol.21Issue(22)：3458-3463,6.DOI:10.3969/j.issn.2095-4344.2017.22.003
自体颗粒骨结合骨泥打压植骨治疗成人Crowe Ⅲ型先天性髋关节发育不良伴髋臼缺损
Impaction bone grafting with morselized bone and bone paste for acetabular defects in adult Crowe Ⅲ type developmental dysplasia of the hip
摘要
Abstract
BACKGROUND:Considering the risk of lack of bone in revision and the bone coverage of component,it is advisable to use bone grafting to increase bone stock in patients with adult Crowe type Ⅲ developmental dysplasia of the hip (DDH) in the first total hip arthroplasty (THA).OBJECTIVE:To investigate the effectiveness of impaction bone grafting with morselized bone and bone paste for acetabular defects of adult Crowe type Ⅲ DDH in THA.METHODS:Forty cases (45 hips) of Crowe type Ⅲ DDH were enrolled,including 8 males and 32 females,aged 31-68 years.All the components were reconstructed at the anatomic acetabulum combined with deepening acetabulum and putting the centre of rotation medially and distally during THA procedures.The patients were all followed up and evaluated with Harris score,limp length,displacement of the centre of rotation,cup coverage,and postoperative complications.RESULTS AND CONCLUSION:The average follow-up was 32.7 months.Acetabular rotation centers of all the cases were recovered (near) to normal.The incisions healed by first intention and there was no complication such as infection,dislocation,prosthesis loosening.The acetabular cup prosthesis did not displace and was covered well by bone at the last follow-up,the grafted bone particles got radiological osseointegration and the bone sclerosis zone disappeared.No radiolucent lines and screw fracture were detected.The Harris scores of affected hips at the last follow-up were significantly higher than those before surgery(P=0).The average leg length was increased (2.31 ±0.18) cm.The mean cup coverage was 78.1％.The postoperative horizontal and vertical distance of the hip center were shorter than those before surgery (P=0).Reconstructing the acetabulum with autogenous morselized bone graft impaction can effectively restore the acetabular coverage,maintain the stability of acetabular cup and provide better relative bone stock in THA for Crowe type Ⅲ DDH in adult,and moreover,the short-term effect is satisfactory.关键词
生物材料/骨生物材料/人工假体/自体颗粒打压植骨/骨泥/先天性髋关节发育不良/全髋关节置换/髋臼骨缺损/髋臼重建分类
医药卫生引用本文复制引用
吴天昊,郭江,张才东,范忠伟,王森,刘少峰,谭美云..自体颗粒骨结合骨泥打压植骨治疗成人Crowe Ⅲ型先天性髋关节发育不良伴髋臼缺损[J].中国组织工程研究,2017,21(22):3458-3463,6.基金项目
四川省教育厅资助项目(12ZB062)the Funding Project of Sichuan Provincial Education Department,No.12ZB062 （12ZB062）
