The Application And Effect Observation Of The Bone Allograft In The Total Hip Arthroplasty With Acetabular Bone Defect (23 Cases)

As the development of the orthopedic operation methods and materials, the number of the total hip arthroplasty (THA) has increased sharply in recent years, also the surgical technique of the total hip arthroplasty has been more and more mature. However, there also been many questions in the THA to the orthopedic doctor. For example, the actabular bone defect is a simple but difficult problem. There are so many methods to deal with the actabular bone defect, and they have different indications but have different effects. In this paper, we will report the follow-up result of 23 patients been treated with total hip arthroplasty because of actabular bone defect, and analysised the application and effect of bone allograft treated actabular bone defect, with the hope that it can provide reference to clinical work.Objective:To investigate the application of the bone allograft of bone defect in the total hip arthroplasty through 23 cases treated in our hospital, and observe the clinical effect and give some advice to the clinical practice.Method:23 qualified total hip arthroplasty (THA) were enrolled in this study from February 2009 to November 2010 treated in out hospital. They had different type acetabular bone defect and were done different type allograft. They were asked to have regular review after operation and have X-ray examination of the hip joint, and evaluate the function of the hip joint at every review time. The bone defect were classified by Paprosky classfication,14 cases belong to typeâ…¡A,6 cases belong to typeâ…¡B,1 case belongs to typeâ…¡C and 2 cases belong to typeâ…¢A.For diagnosis,10 cases belong to congenital dislocation of the hip and acetabular dysplasia,7 cases belong to acetabular components loosening,3 cases belong to femoral head necrosis,2 cases belong to old fracture of acetabular and femoral head necrosis and 1 case belongs to old fracture of femoral neckResults:All the 23 patients had at least 3 months(main 13.5 months,from 3 months to 24 months).The Harris points increase from 37.1 preoperation to 78.7 point postoperation.In the group of structure allograft,only on case showed translucent zone among actabular compont at X ray but had no clinical symptom,one case had screw fracture and had revision operation.The time of bone healing in the group of morselized bone allograft and mixed allograft group is shorter than the group of structure allograft.The total effective rate is 91.3%.Conclusions:1. The bone allograft is a kind of valuable method to acetabular reconstruction and bone defect of acetabular;2. The bone healing time of morselized bone allograft and mixed group is shorter than structure allograft. When we do the total hip arthroplasty of severe bone defect of actabular,we should use structure allograft united morselized bone allograft.