人工髋关节再置换术中骨移植的应用

目的比较自体骨移植、同种异体骨移植以及混合骨移植的愈后及差别。方法４１例病人移植骨使用自体髂骨和本单位贮存低温冷冻股骨头。自体骨移植１８例,同种异体骨移植８例,混合骨移植１５例。分别在６周、３、６、１２个月及１２个月以上观察Ｘ线片。结果６周时,移植骨为吸收像,约３１％（１３／４１）;３个月时,出现愈合征象约８８％（３６／４１）;６个月时,移植骨重塑开始约３９％（１６／４１）;１２个月时,除４例假体松动的病人外,其余３７例全部出现重塑。４例假体松动的病人中,３例细菌性感染,１例移植骨坏死吸收。另外５例并发症为：术后人工股骨头脱臼１例,股骨干骨折３例,股骨大粗隆不愈合１例。结论移植骨愈合过程中,自体骨与同种异体骨之间,混合骨与自体骨或同种异体骨之间愈合速度及愈合状态无明显差异

Application of bone graft in revision total hip arthroplasty

OBJECTIVE: To compare the differences of bony union in autograft, allograft and their mixture-graft. METHODS: The postoperative X-ray films of revision total hip arthroplasties with acetabular bonegraft were observed in 41 patients. They were women, aged at operation from 44 to 86 years (average 65 years). Follow-up ranged from 12 to 72 months (average 29 months). At the operation, autogenous bone was taken from the iliac-crest and homologous bone was from banked bone i.e. femeral head taken previously. Of these, 18 were autografts, 8 allografts, and 15 mixture-grafts. Bone incorporation was observed postoperatively on 6-week, 3-month, 6-month, 12-month and over 12-month films. RESULTS: At 6 weeks, graft absorption appeared in 31% patients (13/41). At 3 months, bridging trabeculation across the graft-host interface was present in 88% patients, (36/41). At 6 months, graft remodelling began in 39% patients (16/41). At 12 months, graft remodeling was considered in 37 patients, and radiolucent prothesis in 4 (infection in 3 patients and graft absorption). CONCLUSION: No difference is observed in the time and the condition of bone union between autograft and allograft, autograft or allograft and their mixture graft.