同种异体骨板联合ETO在全髋关节翻修中的早期疗效分析

目的 对比研究使用同种异体骨板联合钛缆与仅使用钛缆在全髋关节翻修中应用大粗隆延长截骨术（ETO）的早期临床疗效。方法 回顾性对比分析贵州省人民医院2014年2月至2019年2月行全髋关节翻修时应用ETO的患者资料，共31例。其中，男17例，女14例；年龄37 ～ 83岁，平均63.5岁；根据截骨块固定方式分为观察组和对照组，观察组（15例）使用同种异体骨板联合钛缆，对照组（16例）仅使用钛缆。对比分析两组患者手术时间、术中出血量、术前及术后Harris评分、截骨块愈合时间、术后并发症等。结果 患者均随访12 ～ 67个月，平均33.8个月。两组患者在手术时间及术中出血量上差异均无统计学意义（P>0.05）。所有患者随访期间均未出现假体松动、截骨块移位、假体周围骨折、假体周围感染等并发症。观察组、对照组Harris评分术前与末次随访对比，差异均有统计学意义（P<0.05）。两组患者术前Harris评分对比差异无统计学意义（P>0.05），但术后Harris评分观察组明显优于对照组（P<0.05）。观察组截骨块愈合时间较对照组明显延长，差异有统计学意义（P<0.05）。结论 同种异体骨板联合ETO应用于全髋关节翻修，可以获得良好的早期临床疗效。

Analysis of early clinical effect of allogeneic bone plate combined with ETO in total hip arthroplasty revision

Objective To investigate the early clinical effect of using allogeneic bone plate combined with titanium cable and titanium cable only in the revision of total hip arthroplasty with extended trochanteric osteotomy (ETO). Methods A retrospective comparative analysis was made of 31 patients who underwent total hip arthroplasty revision with ETO from February 2014 to February 2019 at Guizhou Provincial People''s Hospital, including 17 males and 14 females, aged from 37 to 83 years, with an average age of 63.5 years. According to the fixation mode of osteotomy, the patients were divided into observation group and control group. Allogeneic bone plates and titanium cables were used in the observation group (n=15) and titanium cables in the control group (n=16). The operation time, intraoperative blood loss, preoperative and postoperative Harris score, osteotomy healing time and postoperative complications were compared and analyzed between the two groups. Results All patients were followed up from 12 to 67 months (mean 33.8 months). There was no significant difference in operation time and intraoperative blood loss between the two groups. During the follow-up period, there were no complications such as prosthesis loosening, osteotomy displacement, periprosthetic fracture, periprosthetic infection and so on. There were significant differences between the preoperative Harris score and the last follow-up Harris score in the observation group and the control group (P<0.05). There was no significant difference in the preoperative Harris score between the two groups, but the postoperative Harris score in the observation group was significantly better than that in the control group. The healing time of osteotomy in the observation group was significantly longer than that in the control group, and the difference was statistically significant(P<0.05). Conclusion The application of allogeneic bone plate combined with ETO in total hip arthroplasty revision can improve the early clinical effect.