非骨水泥型广泛涂层长柄假体在髋关节翻修股骨轻中度缺损重建中的应用

背景：股骨侧轻中度缺损翻修处理目前没有统一的解决方法。目的：评价非骨水泥型广泛涂层长柄假体在股骨轻中度缺损的髋关节翻修中应用的临床效果。方法：11例非感染性股骨侧轻中度骨缺损患者单髋初次翻修,均采用非骨水泥型广泛涂层长柄假体,其中8例患者行干燥同种异体颗粒植骨,3例患者未植骨。结果与结论：11例均获随访,最短随访时间10个月,最长随访60个月。翻修后切口均为Ⅰ期愈合。末次随访时Harris评分好于翻修前（P〈0.01）。翻修后2年1例股骨假体周围出现3mm透亮带,无明显临床症状,未作处理。患者均未见骨溶解,干燥同种异体颗粒骨融合时间3～9个月,平均5个月。提示,采用非骨水泥型广泛涂层长柄假体对股骨轻中度缺损进行髋关节翻修,可实现假体初始稳定与固定,近期临床疗效满意。

Clinical application of uncemented all-coated long stem prosthesis in mild and moderate femur bone defects during hip revision

BACKGROUND：There is no uniform method to repair mild and moderate femur bone defects during hip revision.OBJECTIVE：To evaluate the clinical outcomes of uncemented all-coated long stem prosthesis in mild and moderate femur bone defect during hip revision.METHODS：Eleven patients had mild and moderate femur bone defects after primary hip arthroplasty,they all received uncemented all-coated long stem prosthesis treatment.Among the 11 patients,8 patients underwent dried bone allograft particles.RESULTS AND CONCLUSION：All the incisions healed by the first intension.All patients were followed up for 10-60 months.There was significant difference in the mean Harris score between preoperation and postoperation（P〈0.01） .X-ray examination showed that continuous radiolucent line of 3 mm occurred in 1 case,and no clinical symptoms were observed.Eight cases with dried bone allograft particles recovered within an average period of 5 months（3-9 months） .The uncemented all-coated long stem prosthesis can provide initial stabilization in repair of mild and moderate femur bone defects during revision hip arthroplasty,and the short-term clinical effects are satisfactory.