Acetabuloplasty with bone grafting in uncemented hip replacement for protrusion
Acetabuloplasty with bone grafting in uncemented hip replacement for protrusion
复制标题
DOI：
10.1007/s00264-015-2804-9
复制
发表时间：
2015-09-01
影响因子：
2.7
通讯作者：
Pop, Tudor Sorin
中科院分区：
文献类型：
--
作者：
Zuh, Sandor-Gyoergy;Zazgyva, Ancuta;Pop, Tudor Sorin
目的 本回顾性研究调查了髋臼前突或髋臼内侧壁厚度不足的原发性髋关节炎患者使用打压植骨进行非骨水泥全髋关节置换术的中期结果。方法通过打压植骨增强髋臼内侧壁，所有病例均植入非骨水泥杯。对髋关节旋转中心、髋臼内侧壁厚度和髋臼杯定位进行放射学评估，并在每次随访时确定Harris髋关节评分。 结果 共有32例患者（39髋）平均随访4.5年，末次随访时Harris髋关节评分显着改善。髋关节旋转中心恢复接近最佳位置。术后立即获得的内侧髋臼壁厚度和髋臼杯位置保持至最后一次随访，没有统计学上的显着差异。所有病例术后一两年均观察到植骨融合，末次随访时无松动或杯移位迹象。 15.4% 的病例发现异位骨化，没有髋关节活动障碍或疼痛的临床证据。 结论 对于髋臼成形术，打压植骨联合植入非骨水泥杯，对于髋臼前突和髋臼内侧壁变薄的原发性髋关节病患者，可取得良好的中期结果。恢复的骨量和内侧髋臼壁厚度使髋关节旋转中心的位置接近最佳位置，这可以提供进一步的长期益处。
Purpose This retrospective study investigated midterm outcomes of uncemented total hip replacement with acetabuloplasty using impacted bone grafts in acetabular protrusion or primary hip arthritis with an inadequate thickness of the medial acetabular wall.Methods The medial acetabular wall was augmented by impaction bone grafting, and an uncemented cup was implanted in all cases. Hip centre of rotation, medial acetabular wall thickness and cup positioning were evaluated radiologically, with the Harris Hip Score determined at each follow-up.Results A total of 32 patients (39 hips) were followed for a mean of 4.5 years, with significant improvement of the Harris Hip Score at the last follow-up. Hip centre of rotation was restored close to the optimal position. Medial acetabular wall thickness and cup position obtained immediately postoperatively were maintained up to the last follow-up, without statistically significant differences. Bone graft integration was observed in all cases by one or two years postoperatively, with no signs of loosening or cup migration at the last follow-up. Heterotopic ossification was identified in 15.4 % of cases, without clinical evidence of hip mobility impairment or pain.Conclusions Impaction bone grafting for acetabuloplasty, associated with the implantation of an uncemented cup, yields good midterm results in patients with acetabular protrusion and with primary hip arthrosis with a thinned medial acetabular wall. The restored bone stock and medial acetabular wall thickness enable the placement of the hip centre of rotation close to the optimal location, which could offer further long-term benefits.