目的 總結(jié)髖臼加強(qiáng)環(huán)（Cage）聯(lián)合同種異體骨植骨重建髖臼在髖關(guān)節(jié)翻修術(shù)中的應(yīng)用及療效。 方 法2006年2月－2010年8月，對14例（14髖）行人工全髖關(guān)節(jié)翻修術(shù)的重度髖臼骨缺損患者采用Cage聯(lián)合同種異體骨植骨重建髖臼。男6例，女8例；年齡45～76歲，平均59.2歲。初次置換至此次翻修術(shù)時間為5～12年，平均7.2年。翻修原因：感染8例，骨溶解及假體松動6例。術(shù)前髖關(guān)節(jié)功能Harris評分為（37.7 ± 5.3）分。髖臼骨缺損按照美國骨科醫(yī)師協(xié)會（AAOS）分型標(biāo)準(zhǔn)：Ⅲ型8例，Ⅳ型6例。 結(jié)果術(shù)后切口均Ⅰ期愈合，無坐骨神經(jīng)損傷、下肢深靜脈血栓形成等并發(fā)癥發(fā)生。患者均獲隨訪，隨訪時間14～62個月，平均44個月。患者疼痛癥狀均明顯緩解或消失。末次隨訪時髖關(guān)節(jié)Harris評分為（89.7 ± 3.2）分，與術(shù)前比較差異有統(tǒng)計學(xué)意義（t= —44.40，P=0.04）。X線片示髖臼假體均無松動，植骨未見明顯吸收，并逐漸與宿主骨融合。 結(jié)論在髖關(guān)節(jié)翻修時，采用 Cage聯(lián)合同種異體骨植骨能有效修復(fù)髖臼骨缺損并重建髖臼，近期療效滿意，遠(yuǎn)期療效尚需進(jìn)一步隨訪觀察。
引用本文： 劉王衛(wèi),楊靜,裴福興,沈彬,周宗科,康鵬德. 髖臼加強(qiáng)環(huán)聯(lián)合同種異體骨植骨重建髖臼在髖關(guān)節(jié)翻修中的應(yīng)用. 中國修復(fù)重建外科雜志, 2012, 26(8): 902-904. doi: 復(fù)制
| 1. | Kerboull M, Hamadouche M, Kerboull L. The Kerboull acetabular reinforcement device in major acetabular reconstructions. Clin Orthop Relat Res, 2000, (378): 155-168. |
| 2. | Madey SM, Callaghan JJ, Olejniczak JP, et al. Charnley total hip arthroplasty with use of improved techniques of cementing. The results after a minimum of fifteen years of follow-up. J Bone Joint Surg (Am), 1997, 79(1): 53-64. |
| 3. | van Egmond N, De Kam DC, Gardeniers JW, et al. Revisions of extensive acetabular defects with impaction grafting and a cement cup. Clin Orthop Relat Res, 2011, 469(2): 562-573. |
| 4. | Moskal JT, Higgins ME, Shen J. Type III acetabular defect revision with bilobed components: five-year results. Clin Orthop Relat Res, 2008, 466(3): 691-695. |
| 5. | Hansen E, Shearer D, Ries MD. Does a cemented cage improve revision THA for severe acetabular defects. Clin Orthop Relat Res, 2011, 469(2): 494-502. |
| 6. | 廉永云, 裴福興, 程驚秋, 等. 金屬網(wǎng)罩結(jié)合異體骨打壓植骨修復(fù)髖臼骨缺損. 中華醫(yī)學(xué)雜志, 2007, 87(23): 1603-1606. |
| 7. | Slooff TJ, Buma P, Schreurs BW, et al. Acetabular and femoral reconstruction with impacted graft and cement. Clin Orthop Relat Res, 1996, (324): 108-115. |
| 8. | Cuckler JM. Management strategies for acetabular defects in revision total hip arthroplasty. J Arthroplasty, 2002, 17(4 Suppl 1): 153-156. |
| 9. | Barrack RL, Burnett SJ. Preoperative planning for revision total hip arthroplasty. J Bone Joint Surg (Am), 2005, 87(12): 2800-2811. |
| 10. | O’Rourke MR, Paprosky WG, Rosenberg AG. Use of structural allografts in acetabular revision surgery. Clin Orthop Relat Res, 2004, (420): 113-121. |
| 11. | Lang JE, Bono JV, Whiddon DR, et al. Stability of revision acetabular components using the rim-fit technique. J Arthroplasty, 2010, 25(1): 128-132. |
| 12. | Shinar AA, Harris WH. Bulk structural autogenous grafts and allografts for reconstruction of the acetabulum in total hip arthroplasty. Sixteen-year-average follow-up. J Bone Joint Surg (Am), 1997, 79(2): 159-168. |
| 13. | Lee PT, Raz G, Safir OA, et al. Long-term results for minor column allografts in revision hip arthroplasty. Clin Orthop Relat Res, 2010, 468(12): 3295-3303. |
| 14. | 王迪凡, 喻飛, 楊波, 等. 髖關(guān)節(jié)翻修術(shù)中髖臼骨缺損的處理與重建. 實用骨科雜志, 2011, 17(1): 20-23. |
| 15. | Christie MJ, Barrington SA, Brinson MF, et al. Bridging massive acetabular defects with the triflange cup: 2- to 9-year results. Clin Orthop Relat Res, 2001, (393): 216-227. |
- 1. Kerboull M, Hamadouche M, Kerboull L. The Kerboull acetabular reinforcement device in major acetabular reconstructions. Clin Orthop Relat Res, 2000, (378): 155-168.
- 2. Madey SM, Callaghan JJ, Olejniczak JP, et al. Charnley total hip arthroplasty with use of improved techniques of cementing. The results after a minimum of fifteen years of follow-up. J Bone Joint Surg (Am), 1997, 79(1): 53-64.
- 3. van Egmond N, De Kam DC, Gardeniers JW, et al. Revisions of extensive acetabular defects with impaction grafting and a cement cup. Clin Orthop Relat Res, 2011, 469(2): 562-573.
- 4. Moskal JT, Higgins ME, Shen J. Type III acetabular defect revision with bilobed components: five-year results. Clin Orthop Relat Res, 2008, 466(3): 691-695.
- 5. Hansen E, Shearer D, Ries MD. Does a cemented cage improve revision THA for severe acetabular defects. Clin Orthop Relat Res, 2011, 469(2): 494-502.
- 6. 廉永云, 裴福興, 程驚秋, 等. 金屬網(wǎng)罩結(jié)合異體骨打壓植骨修復(fù)髖臼骨缺損. 中華醫(yī)學(xué)雜志, 2007, 87(23): 1603-1606.
- 7. Slooff TJ, Buma P, Schreurs BW, et al. Acetabular and femoral reconstruction with impacted graft and cement. Clin Orthop Relat Res, 1996, (324): 108-115.
- 8. Cuckler JM. Management strategies for acetabular defects in revision total hip arthroplasty. J Arthroplasty, 2002, 17(4 Suppl 1): 153-156.
- 9. Barrack RL, Burnett SJ. Preoperative planning for revision total hip arthroplasty. J Bone Joint Surg (Am), 2005, 87(12): 2800-2811.
- 10. O’Rourke MR, Paprosky WG, Rosenberg AG. Use of structural allografts in acetabular revision surgery. Clin Orthop Relat Res, 2004, (420): 113-121.
- 11. Lang JE, Bono JV, Whiddon DR, et al. Stability of revision acetabular components using the rim-fit technique. J Arthroplasty, 2010, 25(1): 128-132.
- 12. Shinar AA, Harris WH. Bulk structural autogenous grafts and allografts for reconstruction of the acetabulum in total hip arthroplasty. Sixteen-year-average follow-up. J Bone Joint Surg (Am), 1997, 79(2): 159-168.
- 13. Lee PT, Raz G, Safir OA, et al. Long-term results for minor column allografts in revision hip arthroplasty. Clin Orthop Relat Res, 2010, 468(12): 3295-3303.
- 14. 王迪凡, 喻飛, 楊波, 等. 髖關(guān)節(jié)翻修術(shù)中髖臼骨缺損的處理與重建. 實用骨科雜志, 2011, 17(1): 20-23.
- 15. Christie MJ, Barrington SA, Brinson MF, et al. Bridging massive acetabular defects with the triflange cup: 2- to 9-year results. Clin Orthop Relat Res, 2001, (393): 216-227.