全髋关节翻修术中髋臼假体的选择和髋臼骨缺损的修复效果  

Selection of acetabulum prosthesis in total hip revision procedures and repair effect of the acetabulum bone defect

作　　者：刘如月[1] 郝玉梅[2] 

机构地区：[1]河南商丘市第一人民医院骨科,476100 [2]商丘医学高等专科学校护理系

出　　处：《中国实用医刊》2016年第10期57-58,共2页Chinese Journal of Practical Medicine

摘　　要：目的：探讨全髋关节翻修术中髋臼假体的选择和髋臼骨缺损的处理效果。方法选择2010年1月至2014年1月需行全髋关节翻修术患者24例，术前依据初次手术类型及骨缺损情况制作髋臼及股骨骨床断层模型，根据断层模型选择植骨材料及髋臼假体，均采取全髋关节翻修术治疗，观察患者疗效。结果24例患者均完成手术，术后 Harris 评分均高于术前，差异有统计学意义（P ＜0.05）。24例患者平均随访36个月，术后脱位1例，经手法复位及下肢固定2周维持，骨溶解伴有髋疼痛3例，经非甾体类药物治疗后好转，未见深静脉血栓、切口感染等术后并发症。结论全髋关节翻修术中髋臼假体的选择应结合患者初次手术类型及骨缺损情况，髋臼骨缺损少则采取自体髂骨颗粒骨移植，缺损较多则采取同种异体颗粒骨加自体颗粒骨混合应用，可取得较佳效果。Objective To explore the selection of acetabulum prosthesis on total hip revision procedures and the repair effect of the acetabulum bone defect. Methods 24 patients requiring total hip revision procedures were selected from January 2010 to January 2014,and made acetabulum and femoral bone bed fault model according to the first surgery and bone defect in preoperative,and selected aggre-gate and acetabulum prosthesis according to the fault model. All of the patients were given total hip revi-sion procedures,and the effects of them were observed. Results Twenty-four patients had completed surgery,the postoperative Harris scores was higher than that of preoperative,and the difference was significant（ P 〈 0. 05）. The 24 patients were followed for 36 months,and there was 1 case of post-operative patients with dislocation by manual reduction and limb immobilization 2 weeks without dis-location,3 cases with bone dissolve with hip pain,and they had made improvement after treatment with non-steroidal drugs. There had no complication such as deep vein thrombosis or,infection of in-cision. Conclusions The acetabulum prosthesis selection of total hip revision procedures should com-bine with the conditions of patients with primary surgical type and bone defect,less acetabulum femoral defect taking autogenous iliac bone graft particles,and more defects should take bone allograft particles plus autologous bone particles mixed application,thus obtaining better effect.

关 键 词：全髋关节翻修术 髋臼假体 骨缺损 

分 类 号：R687.4[医药卫生—骨科学]