生物型髋臼假体联合颗粒骨植骨在髋臼缺损髋关节置换术中的临床应用  

Clinical application of bone in the acetabular defects in total hip replacement biological acetabular prosthesis combined with bone graft

作　　者：黄崇新[1] 吕波[1] 王跃[1] 庞健[1] 郝鹏[1] 

机构地区：[1]四川省医学科学院四川省人民医院骨科,四川成都610072

出　　处：《临床和实验医学杂志》2016年第18期1793-1795,共3页Journal of Clinical and Experimental Medicine

基　　金：四川省卫计委科研基金资助项目(编号05SG022-037)

摘　　要：目的探讨生物型髋臼假体联合颗粒骨植骨在髋臼缺损髋关节置换术中的临床应用价值。方法选取收治的90例合并髋臼缺损并首次行人工全髋关节置换手术患者,根据其不同的手术方式,将其分为观察组46例以及对照组44例,其中观察组行生物型髋臼假体联合颗粒骨植骨术治疗,对照组行生物型髋臼假体植入术治疗,比较术前以及术后1年两组Ⅰ、Ⅱ、Ⅲ型患者髋关节Harris评分,在术前以及术后1年对所有患者采取髋关节X线复查,通过X线检查观察假体周围有无出现透亮带以及移植骨的连续性。采用双能X线骨密度仪在术前以及术后1年行髋臼周围的骨密度(BMD)检查。结果治疗后两组各型患者的Harris评分均较治疗前明显改善,且观察组明显优于对照组;治疗后3、6、12月两组骨密度均较治疗前明显提高,且同一时间点观察组明显优于对照组,组间比较有显著差异(P<0.05)。采用生物型髋臼假体植骨术后1年复查X线可见髋臼周围无出现透亮带,植骨愈合满意,联合治疗术后1年复查X线显示骨小梁连续,无出现透亮带。结论生物型髋臼假体联合颗粒骨植骨术应用于人工全髋关节置换术中能够有效重建假体,使髋臼假体的覆盖率得到提高,能够帮助稳定假体和术后髋关节功能恢复,提高骨密度,值得临床推广应用。Objective To investigate the biological type acetabular prosthesis with bone graft in the acetabular defects in total hip replacement clinical value. Methods 9 0 cases with acetabular defects and the first artificial total hip replacement surgery patients were selected according to the different operation mode. They were divided into the observation group （46 cases） and control group （44 cases） . The observa-tion group was treated with biological type acetabular prosthesis combined with morselized bone graft surgery treatment, the control group was treated with biological type acetabular prosthesis implantation treatment. Hip Harris score before and after operation in two groups Ⅰ, Ⅱ and Ⅲ patients were compared, all patients take hip X - ray examination to observe whether there was periprosthetic appear through bright band and transplantation of bone continuity in preoperative and postoperative 1 year. Dual energy X - ray absorptiometry in preoperative and postoperative 1 years is performed for periacetabular bone mineral density （BMD） examination. Results The Harris hip scores of the patients in the two groups after treatment was significantly improved and that of the observation group was better than that the control group. After treatment 3,6, 12 months, bone density was significantly improved and at the same the bone density of observation group was significantly better than that of the control group with significant difference （ P 〈 0. 0 5 ） . No radiolucent zone were showed after the biological type acetabular prosthesis graft, and bone graft healed with satisfactory. Combined treatment of postoperative 1 year review of X - ray showed bone trabecula continuous, non transparent. Conclusion Biological type acetabular prosthesis combined with morselized bone graft bone surgery in total hip arthroplasty can effectively reconstruct prosthesis, the acetabular coverage is improved. It can help stabilize prosthesis and hip function recovery and improve bone density,

关 键 词：髋臼缺损 生物型髋臼假体 颗粒骨植骨 髋关节置换 

分 类 号：R687.4[医药卫生—骨科学]