Use of Structural Bone Graft for Reconstruction of Acetabular Defects in Primary Total Hip Arthroplasty: A 13-year Experience: 在全髖置換手術中以股骨頭結構性移植來重建髖臼缺損----十三年的經驗總結

Background/PurposeThe purpose of this study was to evaluate the clinical and radiographic outcomes of primary cementless total hip arthroplasty (THA) with acetabular defect reconstruction using structural bone grafts.MethodsBetween 2001 and 2012, 10 hips in eight patients with uncontained superolateral acetabular bone defects were reconstructed with femoral head grafts at the time of primary cementless THA. The mean age at surgery was 61.7 years. Patients were followed-up for a mean of 5.8 years for evaluation.ResultsWith either revision or loosening as endpoints, the survival rate of the structural grafts was 100%. Significant improvements in clinical outcomes in terms of the Visual Analogue Scale for Pain (from 9.5 to 3.3, p = 0.005) and Harris Hip Score (from 32.7 to 73.9, p = 0.005) were noted.ConclusionUncontained superolateral acetabular bone defects can be effectively reconstructed with structural bone grafts during primary THA, with excellent short- to midterm survival rate and significantly improved clinical outcomes.

中文摘要本研究評估非水泥全髖置換手術中，髖臼缺損重建術的臨牀及Ｘ光結果。本院於2001年至2012年間，對8位病人共10個有上側方節段性缺損的髖臼以股骨頭結構性移植重建。病人手術時的平均年齡為61.7歲，而他們術後的平均覆診年期為5.8年。以翻修手術或假體鬆脫為基準，移植物的存活率為100%。手術後，病人對痛楚的視覺模擬評分(Visual Analog Scale for Pain, 9.5分跌至 3.3分, p = 0.005)及哈氏髖關節評分(Harris Hip Score, 32.7分升至 73.9分, p = 0.005)亦顯著較手術前為佳。總括而言，在非水泥全髖置換手術中，股骨頭結構性移植重建術能有效地重建上側方節段性缺損的髖臼，從而在短期至中期內達到極佳的移植物存活率及臨牀結果的顯著改善。