The current role of structural grafts and cages in revision arthroplasty of the hip
The current role of structural grafts and cages in revision arthroplasty of the hip
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DOI：
10.1097/01.blo.0000149822.49890.5e
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发表时间：
2004-12-01
影响因子：
4.2
通讯作者：
Goodman, S
中科院分区：
文献类型：
--
作者：
Gross, AE;Goodman, S
髋臼占髋臼50%以上的大型节段性髋臼缺损的治疗是髋关节翻修术中最困难的挑战之一。其中一个手术选择是结构性同种异体髋臼移植。除非这些同种异体移植物受到从髂骨延伸到坐骨的笼子的保护，否则移植物失败的发生率是不可接受的。该融合器可以在正确的解剖水平上进行重建。它为骨移植(结构性和颗粒化)提供了支架。使用水泥来稳定杯子，使得外科医生可以独立于笼子调整杯子的位置。当前一代的笼子不提供生物固定，随着时间的推移可能会松动或断裂。最近的经验表明，骨小梁金属壳由支架保护的组合可能为植骨和杯状支架结构的永久生物固定提供更有利的环境。
Treating large segmental acetabular defects that comprise more than 50% of the acetabulum is one of the most difficult challenges in revision arthroplasty of the hip. One of the surgical options is a structural acetabular allograft. Unless these allografts are protected by a cage that extends from ilium to ischium, there is an unacceptable incidence of graft failure. The cage allows reconstruction at the correct anatomic level. It provides a scaffold for bone grafting (structural and morsellized). The use of cement to stabilize the cup allows the surgeon to adjust the cup position independent of the cage. The current generation of cages does not provide biologic fixation and with time may loosen or fracture. Recent experience with a combination of a trabecular metal shell protected by a cage may offer a more favorable environment for bone grafting with permanent biologic fixation of the cup cage construct.