CAJ | 학술논문

目的评估非骨水泥髋臼及金属髋臼支架加植骨修复髋臼骨缺损的效果.方法我院自2001年9月至2008年9月应用髋臼翻修支架行髋关节翻修术22例(24髋).其中Lima非骨水泥人工翻修髋臼2例(2髋),Kerboull 支架2例(2髋),GAP 髋臼翻修支架18例(20髋).男性6例(6髋),女性16例(18髋).平均年龄62岁(34～79岁).感染性松动2例(2髋),无菌松动20例(22髋).平均随访时间48个月(18～84个月),对其进行临床和影像学评估.Harris评分术前平均为56分(44～75分).结果末次随访时22例患者Harris评分平均为89分(78～94分).优良率为95.5%(21/22).三种髋臼翻修支架的外展角满意,髋臼旋转中心基本得到了重建.髋臼翻修支架及其聚氯乙烯臼无明显移位,假体周围无透亮线,髋臼植骨愈合良好.结论应用非骨水泥髋臼或髋臼支架修复髋臼侧巨大骨缺损,重建了髋臼正常旋转中心、提供了翻修假体的初期稳定性、避免了所植骨在血管化时期的过度机械负重,是翻修髋臼巨大骨缺损的可靠方法.
목적 평고비골수니관구급금속관구지가가식골수복관구골결손적효과.방법 아원자2001년9월지2008년9월응용관구번수지가행관관절번수술22례(24관).기중Lima비골수니인공번수관구2례(2관),Kerboull 지가2례(2관),GAP 관구번수지가18례(20관).남성6례(6관),녀성16례(18관).평균년령62세(34～79세).감염성송동2례(2관),무균송동20례(22관).평균수방시간48개월(18～84개월),대기진행림상화영상학평고.Harris평분술전평균위56분(44～75분).결과 말차수방시22례환자Harris평분평균위89분(78～94분).우량솔위95.5%(21/22).삼충관구번수지가적외전각만의,관구선전중심기본득도료중건.관구번수지가급기취록을희구무명현이위,가체주위무투량선,관구식골유합량호.결론 응용비골수니관구혹관구지가수복관구측거대골결손,중건료관구정상선전중심、제공료번수가체적초기은정성、피면료소식골재혈관화시기적과도궤계부중,시번수관구거대골결손적가고방법.
Objective To evaluate the effects of cementless revising cup or acetabular reinforcement cages for reconstructing the massive acetabular deficiency.Methods From September 2001 to September 2008,22 loosening acetabular cases(24 hips)were revised using cementless revising cup or acetabular reinforcement cases for reconstructing massive bone defect after particulate bone grafting.There were 2 cases (2 hips)using Lima cementless revising cup,2 cases(2 hips)using Kerboull ring,and 18 cases(20hips)using restoration GAP cages.Six cases(6 hips)were male,and 16 cases(18 hips)were female.The mean age was 62 years old(34-79 years old).Septic loosening was in 2 cases(2 hips),and aseptic loosening in 20 cases(22 hips).The mean follow-up was 48 months(18-84 months).Results There was no clinical or radiological evidence of loosening for the revising acetabular components at the last follow-up point.The mean Harris hip score was improved significantly from 56 points(44-75)before revision to 89 points(78-94)at the last follow-up after revision.Excellent and good rate was 95.5%(21/22 cases).The average abduction angle of the three types of acetabular reconstructive cages were 50.1°(39.0°-66.0°),and almost all cases of the hip rotation center were restored after revision surgery.At the last follow-up,the reinforcement cages were no immigration and breakup,and there was no radiolucent line around the acetabular components.The bone graft integrated well into surrounding acetabular bone.Conclusion The method of revising the massive acetabular bone defect by cemenfless revising cup and acetabular reinforcement cages restores the normal hip rotation center,supplies the primary stability of the revising component,and protects the bone graft from mechanical overload during its revascularization phase,which is a reliable method for revising the massive acetabular deficiency after total hip arthroplasty.