Reconstruction of the Severely Deficient Acetabulum with the Bipolar Prosthesis and Allo-Autograft

本文報告四例使用雙極性半人工髖關節，並以自體及異體骨移植術重建髖臼之巨大骨頭缺損，來重做失敗之人工髖關節病例之臨床和X光成果。這些病人之追蹤期從12月到17個月之間(平均14個月)，臨床功能是依據修改自d’Aubigne之髖關節功能評分表來評估，其滿分為18分。術前病人之臨床功能在1分到5分間(平均3.25分)，最近之檢查可見患側髖關節之功能明顯改善到13到17分之間(平均15.25分)。同時，所有受檢查之髖關節的疼痛程度均很輕微。手術時，我們先以整塊之冷凍異體骨來重建髖臼之結構缺損並以取自腸骨之小塊自體海綿骨來填補剩餘之空隙，然後再選用可使用之最大尺寸雙極性半人工髖臼來替換失敗之人工髖關節手術。我們發現以這種方法處理此種有嚴重髖臼骨缺損的手術可減少很多困難，並有不錯之效果。在最近之術後X光檢查發現臼杯之移動情形幾乎沒有或極輕微。但因我們之追蹤期尚短，也許在將可能仍會有臼杯之移動產生。雖然我們採用之手術，原來之構想只是一分期步驟之前半部而已，但似乎單此手術，在對處理有極嚴重骨缺損之髖臼時亦可提供令病人滿意之功能而可當成永久性之手術。當然，我們需要更多病例數及更長追蹤期來支持此一論點。

關鍵字

無資料

並列摘要

We reviewed the clinical results and radiographs of four patients who had revision of the acetabular component of a failed total hip arthroplasty with a bipolar socket supplemented by autoallograft to reconstruct massive bony defect. These patients were followed up from twelve to seventeen months. The clinical score was assessed by a modified d'Aubigne's rating score that assigned a maximum of 18 points. The preoperative clinical score ranged from 1 to 5 points (mean: 3.25 points). The postoperative score improved to a range of 13-17 points (mean: 15.25 points). Of the hips examined, nearly all were pain-free. The largest possible bipolar cup was used with solid structural allografting augmented by morseled cancellous autograft. These have been uniformly trouble-free with acetabular reconstitution. Cup migration was minimal or none. The follow-up periods were short and some migration is probable to be anticipated in the future. Although this technique was originally conceived as part of a staged procedure, it seemed as a definitive procedure yielding acceptable results for dealing with a severely deficient acetabulum. Larger series and longer periods of follow-up are demanded to support this assertion.

並列關鍵字

allografe ； hip prosthesis ； revision atrhroplasty

國際替代計量

Reconstruction of the Severely Deficient Acetabulum with the Bipolar Prosthesis and Allo-Autograft

全文下載

主題瀏覽