生物型大臼杯在THA术后髋臼骨缺损翻修中的应用

发布时间：2018-01-19 12:01

  本文关键词： 全髋关节置换术 髋臼 翻修 重建 骨移植　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨在THA术后髋臼骨缺损翻修中应用生物型大臼杯联合打压植骨技术进行髋臼翻修的早期疗效。方法:研究分析了新疆自治区人民医院骨科中心,自2008年3月至2015年6月收治的27例(27髋)应用生物型大臼杯联合打压植骨技术进行髋臼翻修患者。其中男11例(11髋),女16例(16髋),平均年龄64.58(42-77)岁。翻修的原因:无菌性松动21髋,脱位4髋,髋臼假体磨损2髋。本组患者均为单侧翻修,距THA间隔为10月-25年,平均为10.05年。其中应用骨水泥型髋臼假体11髋,非骨水泥髋臼假体16髋。髋臼骨缺损程度依据Paprosky分类法:Ⅰ型5髋,ⅡA型10髋,ⅡB型7髋,ⅡC型3髋,ⅢA型2髋。应用生物型大臼杯假体联合打压植骨技术对髋臼侧进行翻修,术后定期随访。采用Harris方法及视觉模拟评分法(Visual Analogue Scale,VAS)评分评估髋关节功能恢复情况,根据术后随访X线片判断假体稳定性及植骨融合情况。结果:本组27例(27髋)中有4例失访,其余23例(23髋)均获得有效随访,平均随访时间为39.53个月(13-85个月)。至末次随访:患侧髋关节Harris评分由(41.18±7.59)分提高至(89.76±6.54)分,P0.05;Vas评分由(4.82±0.88)分提高至(0.39±0.62)分,P0.05。3例患者术后假体脱位,给予手法复位后康复。随访X线提示植入髋臼假体及螺钉固定良好,假体位置未见移位,植骨区骨融合情况良好,未见明显骨吸收。无再次翻修病例。结论:应用生物型大臼杯联合打压植骨技术对THA术后髋臼骨缺损进行翻修,早期疗效满意,但中长期疗效仍待进一步观察。
[Abstract]:Objective: to investigate the early effect of acetabular revision in the revision of acetabular defect after THA. Methods: the orthopaedic center of Xinjiang Autonomous region people's Hospital was studied and analyzed. From March 2008 to June 2015, 27 patients (11 hips, 11 males) underwent acetabular revision with biotype acetabular cup combined with bone grafting. The average age of 16 female patients was 64.58 (42-77) years old. The causes of revision were aseptic loosening in 21 hips, dislocation in 4 hips and acetabular prosthesis wear in 2 hips. The interval between THA and THA was from October to 25 years, with an average of 10.05 years. The cement acetabular prosthesis was used in 11 hips. The degree of acetabular defects was based on Paprosky classification: type 鈪，

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