Total hip arthroplasty with onlay bone graft for treatment of severe adult hip dysplasia

doi:10.3969/j.issn.2095-4344.2014.26.004

Abstract

Abstract:

BACKGROUND: Joint replacement surgery becomes difficult because of the abnormal changes in hip joint, especially on the acetabular side. Therefore, the treatment on acetabulum is very important during total hip arthroplasty in patients with hip dysplasia.
OBJECTIVE: To investigate the clinical therapeutic effects of total hip arthroplasty with onlay bone graft for treatment of CroweIII and IV adult hip dysplasia.
METHODS: A total of in 14 patients with adult hip dysplasia were retrospectively analyzed. According to Crowe method, there were 11 cases of type III and 3 cases of type IV. All patients underwent total hip arthroplasty. Autologous femur neck was used to make an onlay bone graft around the acetabulum during replacement. Radiographs were analyzed after replacement and during follow-up. Clinical efficacy was assessed using Harris standard.
RESULTS AND CONCLUSION: All patients were followed up for 1-9 years, averagely 4.5 years. Bone graft was partially absorbed within 1 year after replacement in 4 patients, and began to grow 2 years later. Radiographs showed that all bone graft was fused to host bone. The average coverage rate of bone grafts on acetabulum was 36%. None hip was needed to be rebuilt up to now. Harris score of hip joint function increased from 35 points (26-52 points) before surgery to 91 points during final follow-up. Total hip arthroplasty with onlay bone graft is an effective method in treatment of CroweIII and IV adult hip dysplasia.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: hip joint, arthroplasty, replacement, hip, bone transplantation

CLC Number:

R318

Liu Hong-ming, Zhu Ji-gui, Ye Zheng, Zhu Jian, Zhu Zhi-jun, Sun Si-xin . Total hip arthroplasty with onlay bone graft for treatment of severe adult hip dysplasia[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(26): 4120-4124.

Figures/Tables 3

References

[1]刘宏鸣,孙俊英,叶峥,等.采用C2锥形扁柄假体行生物学固定型全髋关节置换术的中期疗效[J].中华创伤骨科杂志,2013,15(2): 118-122.
[2]Ogino D, Kawaji H, Konttinen L, et al. Total hip replacement in patients eighty years of age and older. J Bone Joint Surg Am. 2008;90(9):1884-1890.
[3]Keisu KS, Mathiesen EB, Lindgren JU. The uncemented fully textured Lord hip prosthesis: a 10- to 15-year followup study. Clin Orthop Relat Res. 2001;(382):133-142.
[4]王彩梅,周学玉,贺靠团.国人生物固定型股骨柄假体几何设计系统方法[J].生物材料与临床研究,2006,4(3):48-53.
[5]刘瑞宇,王坤正,王春生,等.不同程度髋关节发育不良继发骨性关节炎的全髋关节置换术疗效分析[J].中国矫形外科杂志,2008, 16(21):1613-1615.
[6]杨同其,缪烨,徐耀增,等.髋关节发育不良的严重程度与骨水泥型全髋关节置换术后髋臼假体松动的相关性[J].中国骨与关节外科,2009,2(3):175-178.
[7]刘宏鸣,孙俊英,魏立,等.采用锥形股骨柄生物学固定对高龄患者行全髋置换术后的骨改建及临床疗效[J].中华创伤杂志,2010, 26(11):965-971.
[8]孙俊英,郝跃峰,杨沛彦,等.羟基磷灰石涂层股骨柄假体全髋关节置换术的中期疗效[J].中华骨科杂志,2009,29(10):897-900.
[9]孙俊英,郝跃峰,杨沛彦,等.采用羟基磷灰石涂层股骨柄假体行全髋关节置换术的早期疗效[J].中华创伤骨科杂志,2006, 8(10): 27-30.
[10]Mulliken BD, Bourne RB, Rorabeck CH, et al. A tapered titanium femoral stem inserted without cement in a total hip arthroplasty. Radiographic evaluation and stability. J Bone Joint Surg Am. 1996;78(8):1214-1225.
[11]Glassman AH，Bobyn JD，Tanzer M.New femoral designs do they influence stress shielding？Clin Orthop Relat Res. 2006; 453:64-74.
[12]李晓华,吴海山,钱齐荣,等.组配式人工髋关节系统假体治疗CroweⅣ型髋关节发育不良25例疗效分析[J].骨科,2010, 1(1): 12-15.
[13]曹力,阿斯卡尔,张晓岗,等.全髋关节置换术治疗成人发育性髋关节脱位[J].中华关节外科杂志(电子版),2008,2(4):361-366.
[14]Fousek J, Indráková P. Total hip arthroplasty in post-dysplastic hip arthritis. Can type and position of the acetabular component influence longevity of the prosthesis? Acta Chir Orthop Traumatol Cech. 2007;74(1):47-54.
[15]赵建宁,郭亭,周利武,等.成人严重先天性髋脱位的人工全髋关节置换术[J].中国矫形外科杂志,2006,14(5):325-327.
[16]Gill TJ, Sledge JB, Müller ME. Total hip arthroplasty with use of an acetabular reinforcement ring in patients who have congenital dysplasia of the hip. Results at five to fifteen years. J Bone Joint Surg Am. 1998;80(7):969-979.
[17]勘武生,郑琼,黄珩,等.全髋关节置换术治疗髋关节发育不良的髋臼重建[J].中华创伤骨科杂志,2007,9(9):820-823.