The therapeutic effect between metal augment and impacted bone grafting in the hip revision of acetabular bone defect
10.16571/j.cnki.1008-8199.2018.04.007
- VernacularTitle:髋关节翻修金属垫块与颗粒植骨治疗髋臼内上方骨缺损的疗效分析
- Author:
Zhan-Jie CHEN
1
,
2
;
Lei ZHANG
;
Chang-Nian DING
;
Li-Wu ZHOU
;
Ting GUO
;
Ni-Rong BAO
;
Bei-Yue WANG
;
Jian-Ning ZHAO
Author Information
1. 210002 南京,南京军区南京总医院骨科
2. 安徽省宿州市中煤矿建总医院骨科
- Keywords:
acetabular bone defect;
impacted bone graft;
metal augment;
total hip arthroplasty;
revision of acetabular pros-thesis;
Harris score;
HSS score
- From:
Journal of Medical Postgraduates
2018;31(4):373-376
- CountryChina
- Language:Chinese
-
Abstract:
Objective The application of metal augments in the revision of total hip arthroplasty(THA)has achieved re-markable results in the treatment of bone defects.However,there are limited studies compared this effective method with the traditional treatment.The purpose of this article is to investigate the curative effect of both metal augmentation and impacted bone grafting in the revision of acetabular bone defect. Methods We retrospectively analyzed 20 patients(20 hips)with bone defects after THA in Au-thority of Nanjing General Hospital of Nanjing Military Region from August 2010 to February 2017.These 20 patients were allocated into 2 groups:impacted bone grafting group(n=11,filling acetabular bone defect with autogenous iliac bone and artificial bone)and metal aug-mentation group(n=9,filling acetabular bone defect with metal aug-ment).The duration of surgery,blood loss and the hospital for special surgery knee score(HSS)were compared between these two groups and the Harris score was applied to evaluate the hip function and full weight bearing. Results The surgery duration and blood loss of impacted bone grafting group were significantly increased when compared with the metal augmentation group(44.5±7.82 min vs 36.22±5.19 min and 431.82±57.76 mL vs 333.33±72.80 mL respec-tively).there were 3 cases showed mild bone resorption in the I regions in the impacted bone grafting group, while only one case showed mild bone resorption in the II region in the metal augmentation group.The HSS scores in the metal augmentation group were higher than those in the impacted bone grafting group at the time of postoperative 2 weeks(43.89±2.76 vs 40.82±4.42), 3 months (49.89±2.03 vs 45.27±3.90)and 6 months(53.44±2.46 vs 50.55±3.67), the differences were statistically significant(P<0.001). The Harris scores in the metal augmentation group were higher than those in the impacted bone grafting group(P<0.01).The metal augmentation group had a shorter time of getting out of bed compared with the impacted bone grafting group(P<0.01). Conclusion For those patients with upper acetabular bone defect,revision surgery using metal augments can save the operation time.Meanwhile, it is also superior to the impacted bone grafting in the early prosthesis stability and bone ingrowth,and thus enables to shorten the time on getting out of bed and promote functional.
