Efficacy of structural bone graft for reconstruction of acetabulum in total hip arthroplasty in patients with developmental dysplasia of hips and severe acetabular defect

doi:10.3969/j.issn.2095-4344.1397

Abstract

Abstract:

BACKGROUND: For patients with acetabular defect, it may be difficult to place the prosthesis in total hip replacement because of insufficient coverage. Structural bone graft reconstruction of acetabulum can make the prosthesis achieve coverage and stability, but how to obtain better coverage of bone graft is the key to affect the curative effect.

OBJECTIVE: To observe the curative effect of structural bone graft reconstruction for total hip arthroplasty in patients with developmental dysplasia of hips and severe acetabular defects, and to assess the effect of bone graft coverage on repair.

METHODS: Totally 80 patients (100 hips) with severe acetabular defects and hip dysplasia admitted to Department of Bone and Joint Surgery, Gaozhou City Hospital of Traditional Chinese Medicine from February 2010 to February 2016 were selected as the research objects. All patients underwent total hip arthroplasty, with intramedullary reconstruction of the acetabulum with autologous femoral head during operation. The pelvis was examined by X-ray during follow-up. Harris scores were compared between preoperative, postoperative 1 and 2 years. Group allocation was conducted according to graft coverage (≥ 70%, 65%-69%, < 65% in the groups Ⅰ, Ⅱ and Ⅲ, respectively).

RESULTS AND CONCLUSION: (1) Postoperative X-ray evaluation showed that the position of acetabular prosthesis was ideal and the healing of acetabular bone graft was good. Among them, 8 cases had slight bone resorption at the outer edge of acetabular prosthesis, but no prosthesis loosening was found during follow-up. (2) Harris scores 1 year and 2 years after surgery were significantly higher than those before surgery (P=0.000). (3) Host bone coverage was (73.25±1.40)%, and bone graft coverage was (26.75±0.94)% in the Ⅰ group. In the Ⅱ group, there were 32 cases (38 hips) with host bone coverage from 65% to 69%; the host bone coverage was (67.15±0.57)%, and bone graft coverage (32.75±0.46)%. In the Ⅲ group, there were 20 cases (27 hips) with host bone coverage < 65%; the host bone coverage was (55.22±1.10)%, and bone graft coverage (44.78±0.85)%. There was no significant difference in Harris score between Ⅰ group andⅡ group at 1 and 2 years after operation. Harris scores were lower in the Ⅲ group than in the Ⅰ and Ⅱ groups (P=0.000). (4) For patients with developmental dysplasia of hips and severe acetabular defects, reconstruction of the acetabulum with total hip arthroplasty may get a more satisfactory effect. This study was approved by the Ethics Committee of Gaozhou City Hospital of Traditional Chinese Medicine on January 12, 2019 (approval No. GZSZYY83741002).

Key words: developmental dysplasia of hips, total hip arthroplasty, structural bone graft, acetabulum, host bone coverage, bone graft coverage, X-ray, acetabular prosthesis, tissue engineering

CLC Number:

R459.9|R615|R318

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R459.9|R615|R318

Yang Jian, Liang Can, Zhang Huizhong. Efficacy of structural bone graft for reconstruction of acetabulum in total hip arthroplasty in patients with developmental dysplasia of hips and severe acetabular defect[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(32): 5092-5096.

Figures/Tables 4

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