Study On Early And Mid-term Effects Of Combied Bio-acetabular Cup And Bone Graft Technique In The Treatment Of Patients With Acetabular Defect

Objective To investigate the early and mid-term follow-up results of patients w ith huge acetabular bone defects after artificial hip joint replacement using bio-ac etabular cups and bone grafting techniques Methods Thirty patients with acetabular defects who underwent artificial hip arthroplasty from November 2008 to October 2017 in our department of joint surgery were selected as the research objects.The selection criteria were Paprosky ⅡA,Paprosky ⅡB,Paprosky ⅡC,and Paprosky ⅢA.Defective patients were followed up for3 to 12 years,with an average of 8.7 years.There were 14 males and 16 females,aged52 to 83 years,with an average age of 64.5 years.Revision patients were unilateral revision,including 19 cases of right hip and 11 cases of left hip.Reasons for the operation: 27 cases of aseptic loosening of the acetabular prosthesis,1 case of fracture around the femoral stem,and 2 cases of infection around the prosthesis.According to AAOS classification criteria,the acetabular lateral bone defects are divided into: 3 cases of type Ⅰ,8 cases of type Ⅱ,and 19 cases of type Ⅲ;according to Paprosky classification criteria,it is divided into 2 cases of type ⅡA,11 cases of type ⅡB,and 13 cases of type ⅡC,ⅢA4 type example.The outer diameter of the acetabular revision acetabular cup is 60-68 mm,with an average of 62.8 mm.Twenty-six patients used allogeneic bone transplantation,and 4 patients used autologous iliac bone structural bone grafting and allogeneic bone particles mixed bone grafting.Harris scores and VAS scores were used to evaluate hip function before and after the operation,and double hip joint orthotopic radiographs were taken to evaluate the biomolar cup stability and bonegraft invasion.Results All 30 patients in this group were followed up effectively.The results of the last follow-up showed that the Harris score of the affected hip increased from preoperative(43.5 ± 9.94)points to the last follow-up(91.2 ± 4.15)points,and the VAS score from preoperative(5.12 ± 0.46)points decreased to(1.35 ± 0.42)points at the last follow-up.The distance between the center of rotation of the affected hip and the tear line was improved from(35.6 ± 3.52)mm before surgery to(20.1 ± 1.06)mm at the last follow-up.The distance from the center of rotation of the joint to the lateral side of the tear drop improved from(24.8 ± 2.84)mm before surgery to(34.9± 1.46)mm at the last follow-up.The results showed statistically significant differences.At the last follow-up,the anteversion angle(15.67 ± 4.24)degree and abduction angle(40.95 ± 2.71)degree of the biomolecule cup were all shown.Bone areas all have different degrees of bone ingrowth.