新鲜异体软骨移植修复髋关节损伤  

Osteochondral allograft transplantation for repairing hip osteochondral defects

作　　者：王鹏飞[1] 范猛[1] 万彦林 鲍哲恒 马乐 姜文学[1] WANG Peng-fei;FAN Meng;WAN Yan-lin;BAO Zhe-heng;MA Le;JIANG Wen-xue(Department of Orthopedics,The First Central Hospital of Tianjin City,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院骨科,天津300192

出　　处：《中国矫形外科杂志》2021年第5期459-462,共4页Orthopedic Journal of China

摘　　要：[目的]介绍新鲜同种异体软骨移植修复髋关节损伤的手术技术与初步结果。[方法] 2019年3月~2019年5月,对3例股骨头和(或)髋臼骨缺损采用新鲜同种异体软骨移植技术修复,外科脱位暴露髋关节,清除损伤软骨及软骨下骨组织,将新鲜同种异体骨软骨制备成适合大小,嵌压固定于缺损处。[结果]所有患者术后无严重并发症。术后卧床12周,非负重下下肢功能锻炼。术后6周髋关节屈曲活动度达110°。术后3~6个月,由部分负重逐步恢复完全负重行走。术后随访(10.67±1.15)个月,末次随访时,Harris评分、SF-12功能评分、心理评分、VAS评分均较术前显著改善。至末次随访时,影像检查显示移植物与宿主骨愈合,无移植物松动、移位及塌陷。[结论]新鲜异体软骨移植术是修复髋关节缺损的新方式,初步效果满意。[Objective] To introduce the surgical technique and preliminary clinical outcomes of fresh osteochondral allograft transplantation for repairing hip osteochondral defects. [Methods] From March 2019 to May 2019, 3 patients with femoral head and/or acetabular osteochondral defects received fresh osteochondral allograft transplantation. After exposing the joint by surgical hip dislocation technique, the osteochondral lesions were debrided to the normal tissue. Based on the size of the osteochondral defect on the femoral head and/or acetabulum secondary to debridement, the osteochondral allograft was prepared and trimmed. Finally, the graft was put into the defect and fixed by press-fit, and screw fixation added if necessary. [Results] All the patients had operation performed smoothly without serious complication, had rest and rehabilitation excises on bed for 12 weeks with regaining active range of motion more than 110° in 6 weeks.From 3 to 6 months postoperatively, the patients returned to full-weight bearing activity gradually. The Harris, SF-12, psychological and VAS scores significantly improved at the latest follow-up compared with those before operation. In respect of imaging, all 3 patients got bony healing of the graft with host bone without any sign of loosening, displacement and collapse to the latest follow-up. [Conclusion]Fresh osteochondral allograft transplantation is a feasible technique for repairing hip osteochondral defects, does achieve satisfactory preliminary clinical outcome.

关 键 词：异体骨软骨移植 股骨头坏死 软骨损伤 

分 类 号：R687[医药卫生—骨科学]