可降解高纯度镁金属骨钉固定修复发育性髋关节发育不良  

Application of degradable high-purity magnesium screw in the treatment of developmental dysplasia of the hip

作　　者：黄诗博 谢辉[2] 王宗璞[2] 王韦丹 覃开蓉 赵德伟[1,2] Huang Shibo;Xie Hui;Wang Zongpu;Wang Weidan;Qin Kairong;Zhao Dewei(School of Biomedical Engineering,Department of Telecommunication,Dalian University of Technology,Dalian 116001,Liaoning Province,China;Department of Orthopedics,Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,Liaoning Province,China)

机构地区：[1]大连理工大学电信学部生物医学工程学院,辽宁省大连市116001 [2]大连大学附属中山医院骨科,辽宁省大连市116001

出　　处：《中国组织工程研究》2022年第4期493-498,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家卫生部公益项目(201402016),项目名称:基于显微外科的严重肢体组织缺损修复关键技术的优化,规范与评价研究,项目负责人:赵德伟;国家自然科学基金(81672139),项目名称:“可降解纯镁植入螺钉促进缺血性坏死股骨头修复的机理研究”,项目负责人:赵德伟。

摘　　要：背景:发育性髋关节发育不良髋臼缺损患者选择接受全髋关节置换时,髋臼侧的处理对假体安放极为重要,髋臼外上方植骨被证实是一种安全可行的治疗方式,而如何进行植骨成为手术成功的关键因素。目的:探讨在髋臼外上方采用可降解高纯度镁金属螺钉固定植骨联合全髋人工关节置换治疗发育性髋关节发育不良髋臼缺损患者的临床疗效。方法:纳入大连大学附属中山医院收治的7例发育性髋关节发育不良髋臼缺损患者,其中男1例,女6例,年龄54-65岁,按Crowe分型2例Ⅰ型,1例Ⅱ型,2例Ⅲ型,2例Ⅳ型,均进行人工全髋关节置换手术,髋臼侧采用外上方植骨处理缺损增加覆盖,移植骨块采用可降解高纯度镁金属螺钉进行固定。术后随访进行影像学检查与髋关节Harris功能评分、目测类比评分。研究经过大连大学附属中山医院伦理委员会通过(批件号:2013-006)。结果与结论:(1)7例患者随访2-4.5年,患肢短缩由术前的(2.43±0.78) cm下降至术后(0.57±0.56) cm,未见切口感染及不愈合发生,未见假体周围感染出现;(2)7例患者末次随访的目测类比评分低于术前(P <0.05),髋关节功能Harris评分高于术前(P <0.05);(3)影像学检查显示,可降解高纯度镁金属螺钉在术后三四年间全部降解,移植骨块均与髋臼骨性愈合,未见移植骨块脱落及假体松动,所有病例术后未见不良并发症发生;(4)结果表明,对于发育性髋关节发育不良髋臼缺损患者,在髋臼外上方采用可降解高纯度镁金属螺钉固定植骨联合全髋人工关节置换治疗的短期效果满意。BACKGROUND: In the selection of total hip arthroplasty for acetabular defect patients with developmental dysplasia of the hip, the management of the acetabular side is very important for the placement of the prosthesis. The external and upper acetabular bone grafting has been proven to be a safe and feasible treatment method, and how to carry out the bone grafting has become the key factor for the success of the operation.OBJECTIVE: To investigate the clinical effect of external and superior acetabular bone graft combined with total hip arthroplasty in the treatment of acetabular defect in patients with developmental dysplasia of the hip and fixation of bone graft with degradable high-purity magnesium metal screws.METHODS: Seven cases of developmental dysplasia of the hip acetabulum defect patients, with 1 male and 6 females, aged 54-65 years, were included from the Affiliated Zhongshan Hospital of Dalian University. According to Crowe type, there were 2 cases of I type, 1 case of II type, 2 cases of III type, and 2 cases of IV type. All cases underwent artificial total hip arthroplasty. The acetabulum received external and upper acetabular bone grafting and the coverage. The bone grafts were fixed with biodegradable high-purity magnesium metal screw. The imaging examination, Harris hip functional score and visual analogue scale score were performed in the postoperative follow-up. This study was approved by the Ethics Committee of the Affiliated Zhongshan Hospital of Dalian University(approval No. 2013-006).RESULTS AND CONCLUSION:(1) Seven patients were followed up for 2-4.5 years. The shortened affected limb decreased from(2.43±0.78) cm preoperatively to(0.57±0.56) cm postoperatively. No incision infection or nonunion was observed, and no periprosthetic infection was observed.(2) The visual analogue scale score at the last follow-up was lower than that before surgery in seven patients(P < 0.05). Harris score of hip function was higher than that before surgery(P < 0.05).(3) Imaging examination showed that all t

关 键 词：发育性髋关节发育不良 全髋关节置换 髋臼缺损 生物型假体 金属骨钉 镁 镁金属螺钉 

分 类 号：R459.9[医药卫生—治疗学] R615[医药卫生—临床医学]