髖臼加強環聯合同種異體骨植骨重建髖臼在髖關節翻修中的應用_《中國修復重建外科雜志》

作者：

劉王衛 , 楊靜 , 裴福興 , 沈彬 , 周宗科 , 康鵬德

四川大學華西醫院骨科（成都，610041）;

關鍵詞：

髖關節翻修髖臼骨缺損髖臼重建髖臼加強環

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目的總結髖臼加強環（Cage）聯合同種異體骨植骨重建髖臼在髖關節翻修術中的應用及療效。方法2006年2月－2010年8月，對14例（14髖）行人工全髖關節翻修術的重度髖臼骨缺損患者采用Cage聯合同種異體骨植骨重建髖臼。男6例，女8例；年齡45～76歲，平均59.2歲。初次置換至此次翻修術時間為5～12年，平均7.2年。翻修原因：感染8例，骨溶解及假體松動6例。術前髖關節功能Harris評分為（37.7 ± 5.3）分。髖臼骨缺損按照美國骨科醫師協會（AAOS）分型標準：Ⅲ型8例，Ⅳ型6例。結果術后切口均Ⅰ期愈合，無坐骨神經損傷、下肢深靜脈血栓形成等并發癥發生。患者均獲隨訪，隨訪時間14～62個月，平均44個月。患者疼痛癥狀均明顯緩解或消失。末次隨訪時髖關節Harris評分為（89.7 ± 3.2）分，與術前比較差異有統計學意義（t= —44.40，P=0.04）。X線片示髖臼假體均無松動，植骨未見明顯吸收，并逐漸與宿主骨融合。結論在髖關節翻修時，采用 Cage聯合同種異體骨植骨能有效修復髖臼骨缺損并重建髖臼，近期療效滿意，遠期療效尚需進一步隨訪觀察。

引用本文： 劉王衛,楊靜,裴福興,沈彬,周宗科,康鵬德. 髖臼加強環聯合同種異體骨植骨重建髖臼在髖關節翻修中的應用. 中國修復重建外科雜志, 2012, 26(8): 902-904. doi: 復制

1.	Kerboull M, Hamadouche M, Kerboull L. The Kerboull acetabular reinforcement device in major acetabular reconstructions. Clin Orthop Relat Res, 2000, (378): 155-168.
2.	Madey SM, Callaghan JJ, Olejniczak JP, et al. Charnley total hip arthroplasty with use of improved techniques of cementing. The results after a minimum of fifteen years of follow-up. J Bone Joint Surg (Am), 1997, 79(1): 53-64.
3.	van Egmond N, De Kam DC, Gardeniers JW, et al. Revisions of extensive acetabular defects with impaction grafting and a cement cup. Clin Orthop Relat Res, 2011, 469(2): 562-573.
4.	Moskal JT, Higgins ME, Shen J. Type III acetabular defect revision with bilobed components: five-year results. Clin Orthop Relat Res, 2008, 466(3): 691-695.
5.	Hansen E, Shearer D, Ries MD. Does a cemented cage improve revision THA for severe acetabular defects. Clin Orthop Relat Res, 2011, 469(2): 494-502.
6.	廉永云, 裴福興, 程驚秋, 等. 金屬網罩結合異體骨打壓植骨修復髖臼骨缺損. 中華醫學雜志, 2007, 87(23): 1603-1606.
7.	Slooff TJ, Buma P, Schreurs BW, et al. Acetabular and femoral reconstruction with impacted graft and cement. Clin Orthop Relat Res, 1996, (324): 108-115.
8.	Cuckler JM. Management strategies for acetabular defects in revision total hip arthroplasty. J Arthroplasty, 2002, 17(4 Suppl 1): 153-156.
9.	Barrack RL, Burnett SJ. Preoperative planning for revision total hip arthroplasty. J Bone Joint Surg (Am), 2005, 87(12): 2800-2811.
10.	O’Rourke MR, Paprosky WG, Rosenberg AG. Use of structural allografts in acetabular revision surgery. Clin Orthop Relat Res, 2004, (420): 113-121.
11.	Lang JE, Bono JV, Whiddon DR, et al. Stability of revision acetabular components using the rim-fit technique. J Arthroplasty, 2010, 25(1): 128-132.
12.	Shinar AA, Harris WH. Bulk structural autogenous grafts and allografts for reconstruction of the acetabulum in total hip arthroplasty. Sixteen-year-average follow-up. J Bone Joint Surg (Am), 1997, 79(2): 159-168.
13.	Lee PT, Raz G, Safir OA, et al. Long-term results for minor column allografts in revision hip arthroplasty. Clin Orthop Relat Res, 2010, 468(12): 3295-3303.
14.	王迪凡, 喻飛, 楊波, 等. 髖關節翻修術中髖臼骨缺損的處理與重建. 實用骨科雜志, 2011, 17(1): 20-23.
15.	Christie MJ, Barrington SA, Brinson MF, et al. Bridging massive acetabular defects with the triflange cup: 2- to 9-year results. Clin Orthop Relat Res, 2001, (393): 216-227.

1. Kerboull M, Hamadouche M, Kerboull L. The Kerboull acetabular reinforcement device in major acetabular reconstructions. Clin Orthop Relat Res, 2000, (378): 155-168.
2. Madey SM, Callaghan JJ, Olejniczak JP, et al. Charnley total hip arthroplasty with use of improved techniques of cementing. The results after a minimum of fifteen years of follow-up. J Bone Joint Surg (Am), 1997, 79(1): 53-64.
3. van Egmond N, De Kam DC, Gardeniers JW, et al. Revisions of extensive acetabular defects with impaction grafting and a cement cup. Clin Orthop Relat Res, 2011, 469(2): 562-573.
4. Moskal JT, Higgins ME, Shen J. Type III acetabular defect revision with bilobed components: five-year results. Clin Orthop Relat Res, 2008, 466(3): 691-695.
5. Hansen E, Shearer D, Ries MD. Does a cemented cage improve revision THA for severe acetabular defects. Clin Orthop Relat Res, 2011, 469(2): 494-502.
6. 廉永云, 裴福興, 程驚秋, 等. 金屬網罩結合異體骨打壓植骨修復髖臼骨缺損. 中華醫學雜志, 2007, 87(23): 1603-1606.
7. Slooff TJ, Buma P, Schreurs BW, et al. Acetabular and femoral reconstruction with impacted graft and cement. Clin Orthop Relat Res, 1996, (324): 108-115.
8. Cuckler JM. Management strategies for acetabular defects in revision total hip arthroplasty. J Arthroplasty, 2002, 17(4 Suppl 1): 153-156.
9. Barrack RL, Burnett SJ. Preoperative planning for revision total hip arthroplasty. J Bone Joint Surg (Am), 2005, 87(12): 2800-2811.
10. O’Rourke MR, Paprosky WG, Rosenberg AG. Use of structural allografts in acetabular revision surgery. Clin Orthop Relat Res, 2004, (420): 113-121.
11. Lang JE, Bono JV, Whiddon DR, et al. Stability of revision acetabular components using the rim-fit technique. J Arthroplasty, 2010, 25(1): 128-132.
12. Shinar AA, Harris WH. Bulk structural autogenous grafts and allografts for reconstruction of the acetabulum in total hip arthroplasty. Sixteen-year-average follow-up. J Bone Joint Surg (Am), 1997, 79(2): 159-168.
13. Lee PT, Raz G, Safir OA, et al. Long-term results for minor column allografts in revision hip arthroplasty. Clin Orthop Relat Res, 2010, 468(12): 3295-3303.
14. 王迪凡, 喻飛, 楊波, 等. 髖關節翻修術中髖臼骨缺損的處理與重建. 實用骨科雜志, 2011, 17(1): 20-23.
15. Christie MJ, Barrington SA, Brinson MF, et al. Bridging massive acetabular defects with the triflange cup: 2- to 9-year results. Clin Orthop Relat Res, 2001, (393): 216-227.

《中國修復重建外科雜志》

髖臼加強環聯合同種異體骨植骨重建髖臼在髖關節翻修中的應用

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《中國修復重建外科雜志》

髖臼加強環聯合同種異體骨植骨重建髖臼在髖關節翻修中的應用

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