本文關鍵詞： 髖關節(jié)置換 髖臼骨缺損 Paprosky分型 骨移植　出處：《廣西醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：背景:世界范圍內接受髖置換的患者人數(shù)逐年增長,合并骨缺損的髖臼重建已是骨科醫(yī)生常見的難題。修復髖臼的方式有許多,骨移植作為一種經(jīng)典的髖臼重建方式,隨患者條件差異而有不同運用,且療效及預后各不相同,爭議較多。目的:通過對20例行全髖關節(jié)置換手術、并通過顆粒植骨或結構植骨方式修復髖臼側骨缺損的患者進行定期隨訪,對治療效果進行分析,討論髖置換術中髖臼側骨缺損處理應用骨移植技術的療效及選擇。方法:選取我院自2013年11月至2016年12月行全髖關節(jié)置換手術,并通過植骨修復髖臼骨缺損的病例20例20髖,包括3例髖臼發(fā)育不良并髖關節(jié)病、3例股骨頭缺血壞死、14例髖關節(jié)置換術后假體松動,其中按Paprosky分型有Ⅱb型11髖、Ⅱc型1髖、Ⅲa型4髖、Ⅲb型4髖,記錄患髖Harris評分以及VAS評分變化情況,拍攝骨盆平片評價移植骨情況及假體移位或松動程度。對骨缺損類型、植骨方式、功能評分差異及術后相關并發(fā)癥進行評估。結果:共18例患者獲得隨訪,平均隨訪時間18個月(4-40個月),Harris評分由術前37.9±9.8(21-57分)分提高到術后86.4±5.9(75-93分)分,優(yōu)良率達80.0%。1例術后2個月檢查發(fā)現(xiàn)髖臼假體松動后失訪,1例術后2個月發(fā)生髖關節(jié)脫位,考慮假體內陷,再次行髖關節(jié)翻修術,1例術后發(fā)生脫位并行復位術,延長臥床保守治療后未再次脫位,1例術后出現(xiàn)盆腔血腫,考慮髖臼固定螺釘損傷骨盆血管所致。除再次翻修病例外,余患者術后隨訪骨盆平片均未見假體松動現(xiàn)象與移植骨吸收現(xiàn)象。結論:結構植骨與顆粒骨打壓植骨均為全髖關節(jié)置換術中重建髖臼的有效方法,根據(jù)患者條件選擇適宜的修復方案,短期效果理想。
[Abstract]:Background: the number of patients undergoing hip replacement is increasing year by year. The reconstruction of acetabular with bone defect has become a common problem for orthopedic doctors. There are many ways to repair acetabular. Bone graft is a classical method of acetabular reconstruction. The effect and prognosis are different and controversial. Objective: 20 cases of total hip replacement were performed. The patients with acetabular lateral bone defect repaired by granular or structural bone grafting were followed up regularly and the therapeutic effect was analyzed. To discuss the effect and choice of bone graft in the management of acetabular bone defect in hip replacement. Methods: 20 cases (20 hips) with acetabular bone defect were treated with total hip replacement from November 2013 to December 2016 in our hospital. There were 3 cases of acetabular dysplasia, 3 cases of avascular necrosis of femoral head and 14 cases of prosthesis loosening after hip replacement. According to Paprosky classification, there were 11 hips of type 鈪，

本文編號：1535698