金属垫块和颗粒植骨对全髋关节翻修术中髋臼骨缺损的应用效果  

Application Effect of Metal Augment and Morselized Bone Grafting on Acetabular Bone Defects in Total Hip Joint Revision

作　　者：郭予立[1] 胡奕山[1] 刁喜财[1] 林慰光[1] 郑康伟 GUO Yuli;HU Yishan;DIAO Xicai;LIN Weiguang;ZHENG Kangwei(Shantou Central Hospital,Shantou 515031,China)

机构地区：[1]广东省汕头市中心医院,广东汕头515031

出　　处：《中国医学创新》2020年第9期60-63,共4页Medical Innovation of China

基　　金：汕头市科技计划项目(181204034010548)。

摘　　要：目的:用对照法研究金属垫块和颗粒植骨在全髋关节翻修术中髋臼骨缺损的应用效果。方法:选取2014年1月-2018年12月在本院就诊治疗的全髋关节置换术(total hip replacement,THR)后髋臼骨缺损并需行髋关节翻修患者44例。按照随机数字表法将其分为颗粒植骨组和金属垫块组,各22例(22髋)。比较两组围手术期情况、影像学评分、髋关节功能评分、并发症发生情况。结果:金属垫块组手术用时明显短于颗粒植骨组,术中出血量明显少于颗粒植骨组,差异均有统计学意义(P<0.05);金属垫块组术后各区影像学评分均明显高于颗粒植骨组,差异均有统计学意义(P<0.05);两组术后2周、3个月以及6个月的Harris评分均较术前有明显提高,且金属垫块组Harris评分均显著高于颗粒植骨组,差异均有统计学意义(P<0.05);金属垫块组并发症发生率低于颗粒植骨组(P<0.05)。结论:与颗粒植骨比较,金属垫块在治疗髋臼骨缺损中,能够有效缩短手术用时,减少术中出血量,改善患者髋功能,安全可靠。Objective:To study the application effect of metal augment and morselized bone grafting on acetabular bone defects in total hip arthroplasty by control method.Method:From January 2014 to December 2018,44 patients with acetabular bone defect and revision of hip joint after total hip replacement(THR)in our hospital were selected.According to the method of random number table,they were divided into morselized bone grafting group and metal augment group,22 cases(22 hips)in each group.Perioperative situation,imaging score,hip function score and complications of the two groups were compared.Result:The operation time in the metal augment group was shorter than that in the morselized bone grafting group,and the amount of bleeding was less than that in the morselized bone grafting group,the differences were statistically significant(P<0.05).The imaging score of each area in the metal augment group were significantly higher than those in the morselized bone grafting group,the differences were statistically significant(P<0.05).The Harris scores of the two groups at 2 weeks,3 months and 6 months after operation were significantly higher than those before operation,and the Harris scores of the metal augment group were significantly higher than those of the morselized bone grafting group,the differences were statistically significant(P<0.05).The incidence of complications in the metal augment group was lower than that in the morselized bone grafting group(P<0.05).Conclusion:Compared with the morselized bone grafting,the metal augment can effectively shorten the operation time,reduce the amount of intraoperative bleeding and improve the hip function of patients in the treatment of acetabular bone defect,which is safe and reliable.

关 键 词：髋臼骨缺损 颗粒植骨 金属垫块 全髋关节翻修术 

分 类 号：R687.3[医药卫生—骨科学]