全髋关节置换并结构性植骨治疗CroweⅢ型髋臼发育不良性骨关节炎  

Total hip arthrolasty plus structural bone grafting for the treatment of Crowe Ⅲ acetabular dysplasia osteoarthritis

作　　者：袁明武[1] 潘江[2] 张晓冬[2] 

机构地区：[1]广西医科大学第四附院骨科,广西壮族自治区柳州市545005 [2]北京朝阳医院骨科,北京市100020

出　　处：《中国组织工程研究》2012年第39期7227-7231,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:CroweⅢ型髋关节发育不良在继发骨关节炎时需要行全髋关节置换,置换中髋臼的重建是重点和难点。目的:观察全髋关节置换并结构性植骨治疗CroweⅢ型髋臼发育不良性骨关节炎的效果。方法:选择北京朝阳医院骨科2006-01/2009-08收治的CroweⅢ型髋关节发育不良继发骨关节炎患者15例(18髋),均施行了全髋关节置换+髋臼自体结构性植骨。结果与结论:全部患者均获得随访,随访时间12-24个月,平均18个月。所有病例髋臼旋转中心都接近正常,置换前双下肢长度差为2.0-3.5cm,置换后双下肢长度差为0-1.5cm。至末次随访,Harris评分由置换前的平均38分(17-69分)升高至92分(86-96分)。提示CroweⅢ型髋关节发育不良继发骨关节炎的全髋关节置换中,将髋臼重建于真臼内、把髋臼旋转中心内移、辅以结构性植骨,可有效恢复髋臼覆盖、维持臼杯稳定并恢复下肢长度。BACKGROUND： In the cases of total hip arthroplasty, Crowe Ⅲ acetabular dysplasia osteoarthritis needs to be treated with total hip arthroplasty. OBJECTIVE： To observe the effect of total hip arthroplasty plus structural bone grafting for the treatment of Crowe Ⅲ acetabular dysplasia osteoarthritis. METHODS： From January 2006 to August 2009 in Department of Orthopedics, Chaoyang Hospital, Beijing, 15 cases （18 hips） of Crowe Ⅲ acetabular dysplasia osteoarthritis were selected and treated with total hip arthroplasty plus structural bone grafting. RESULTS AND CONCLUSION： All cases were followed-up for 12-24 months, averagely 18 months. Acetabular rotating center of all the cases was back to normal, the preoperative length difference of lower limbs was 2.0-3.5 cm and the postoperative length difference of lower limbs was 0-1.5 cm. To the last follow-up, the average Harris score was increased from preoperative 38 points （17-69 points） to postoperative 92 points （86-96）. During the total hip arthroplasty for the treatment of Crowe Ⅲ acetabular dysplasia osteoarthritis, reconstructed the acetabular in the true acetabulum, regressed the acetabular rotation center, combined with structural bone grafting can effectively restore the acetabular coverage, maintain the stability of acetabular cup and restore leg length.

关 键 词：髋关节发育不良 CroweⅢ型 结构性自体植骨 全髋关节置换 植入体 骨关节炎 髋臼重建 

分 类 号：R318[医药卫生—生物医学工程]