非骨水泥髋臼杯_____非骨水泥髋臼杯；

异体颗粒松质骨移植治疗髋臼杯稳定的髋臼周围骨溶解

http://www.100md.com 《中国矫形外科杂志》 2006年第7期

非骨水泥髋臼杯,,非骨水泥髋臼杯；,骨溶解；,人工全髋关节翻修术；,异体骨；,颗粒型骨移植,1资料和方法,2结果,3讨论,参考文献：

     摘要：[目的]评价异体颗粒松质骨移植治疗THA术后髋臼杯稳定的髋臼周围骨溶解的效果。[方法]自1996年4月~2000年7月，对26例髋臼杯周围骨溶解而假体稳定者行保留髋臼杯，清除病灶、异体颗粒松质骨移植术，并更换聚乙烯内衬和股骨头假体。术后平均随访55 a。对临床结果、骨溶解病变范围和骨移植愈合分别用Harris髋关节评分系统、放射线影像学和骨移植愈合分级系统进行评价。[结果]Harris评分由翻修术前的平均82分增加到术后平均88分；X线片示髋臼杯周围骨溶解范围正位由术前238 mm×249 mm减小到术后115 mm×82 mm，侧位由术前的111 mm×116 mm减少到术后53 mm×45 mm；异体骨愈合程度Ⅰ级12例(46%)，Ⅱ级14例(54%)。[结论]保留髋臼杯、清除病灶后行异体颗粒松质骨移植术是非骨水泥髋臼杯稳定的髋臼周围骨溶解治疗的有效措施，可以保留更多的髋臼骨量，降低手术的复杂程度。

    关键词：非骨水泥髋臼杯；骨溶解；人工全髋关节翻修术；异体骨；颗粒型骨移植

    Morselized bone grafting in osteolysis around the stable cenmentless acetabular cup∥LIAN Yongyun,MyungChul Yoo,PEI Fuxing,et alDepartment of Orthopaedics Surgery,WestChina Hospital of Sichuan University,Chengdu,610041

    Abstract：[Objective]To evaluate the clinical and radiological results of a curettage of granulation tissue,the exchange of polyethylene liner and morselized bone grafting for the treatment of osteolysis around a stable cementless acetabular cup[Method]From Apr1996 to Jul2000,26 patients underwent revision of curettage of granulation tissue,the exchange of polyethylene liner and morselized allografting,which were followed up for an average of 55 yearsThe Harris Hip Score was used to evaluate the clinical resultThe size of osteolysis of periacetabular cup was measured in AP and lateral view of XraysThe allograft union was evaluated with the bone graft incorporation scale[Result]Clinically,the average HHS increased from 82 to 88 points postoperativelyRadiologically,the size of osteolysis of peraacetabular cup changed from average 238 mm×249 mm to 115 mm×82 mm in the AP view,and from 111 mm×116 mm to 53 mm×45 mm in the lateral viewThe bone graft incorporation scales were Grade Ⅰ and Ⅱ in 12 and 14 cases,respectively[Conclusion]The Curettage of granulation tissues,morselized bone grafting and exchange of polyethylene liner and femoral head is an effective therapy in osteolysis around a stable cementless acetabular cup and could preserve the bone stock for the further revision THA ......

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