The Study Of Structural Autograft For Acetabular Reconstruction In Total Hip Arthroplasty Of Developmental Dysplasia Of The Hip

Objective:To explore the surgical method ? curative effect analysis and perioperative considerations of structural autograft for Total Hip Arthroplasty(THA) of Developmental Dysplasia of the Hip(DDH) and secondary osteoarthritis.Materials and methods:30 patients(36 hips)with Developmental Dysplasia of the Hip(DDH) and secondary osteoarthritis were per formed with Total Hip Arthroplasty(THA) in affiliated hospital of shandong university of TCM(Chinese medicine hospital in Shan dong province) during march,2013~march,2015. There are 2 male(2 hips) and 28 female( 34 hips) in the patients which age from 36 to 63 and average age of 54.5 years?According to Crowe rati ng, 23 hips in 20 patients were stage? with 13 hips in 11 patie nts as stage ?. The average of Harris score is 41.41 at the tim e of preoperative. All patients are the first surgery. Structura l Autograft and non bone cement type biological acetabulum prost hesis Applied to the THA. Follow-up matters:(1) We record patien ts' functional status and mark Harris score by telephone and Out patient care.(2)For X-ray in the part of the hip, observe the changes around acetabulum.(3)The recovery of the limb-length discr epancy(LLD) and the correct of the pelvic tilt and lumbar scolio sis.Result:When postoperation 12 months to 24 months, 36 hips in 30 patients were successfully followed up in average 18.3 months.(1) Harris score significantly increase from 41.41 to 91.21.22 patients(24 hips) achieved optimal(Harris score > 90),8 patients(10 hips) achieved good(Harris score in 80-89), 2 patients(2 hips) achieved general(Harris score in 70-79).There is no failure(Harris score<70 points).Fine rate reached 91.18%?(2)There are no wound infection?no deep venous thrombosis?no hip displacement?no the femur and acetabulum fractures ? sciatic nerve injury after operation. In addition to the pain almostly relieved, no restriction was need when walking and going upstairs.For the patients with preoperation limb-length discrepancy(LLD),all regained alost equal limb length postoperation.(3)After the operation for 3 months,X-ray show acetabulum and femoral prosthesis in normal anatomical location,there is no signs of loosening and infection?Graft bones heal satisfactorily and bone interface disappeared,35 patients no obvious bone resorption,ratio accounted for 97.22%. Graft bones heal is not satisfactorily after postoperation 6 months only 1 case, while no clinical symptoms. 1 year later,X-ray show that the Bright belt of the bone disappeared with trabecular reorientation. Graft bones heal satisfactorily.Conclusion: Structural Autograft in Total Hip Arthroplasty of Developmental Dysplasia of the Hip is positive and good for the developmental acetabulum reconstructe effectively. Using this method, the bone covering rate for the acetabulum prosthesis increased, the stability of the prosthesis and The hip joint strengthed. It's all benefit for the recovery of hip function after THA.