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在修复性关节整形手术中使用莫尔塞化骨头全移植用于大规模的骨缺陷:系统性审查和元分析

Pietro Cimatti^1,2, Nicolandrea Del Piccolo¹, Benedetta Dallari¹

¹Reconstructive Orthopaedic Surgery Innovative Techniques-Musculoskeletal Tissue Bank IRCCS Istituto Ortopedico Rizzoli Bologna Italy.

Journal of experimental orthopaedics

|December 5, 2024

概括

修复关节整形手术用于使用morselized全移植的大型关节缺陷显示低失败率. 强化装置增加了感染和脱位的风险,但整体植入物存活率在不同技术之间是可比的.

科学领域:

整形外科手术整形外科手术
生物材料科学生物材料科学

背景情况:

修复性全关节整形术 (THA) 是一个复杂的过程,特别是在大型关节缺陷 (帕普洛斯基型III或AAOS型III-IV) 时.
摩尔塞化整体移植经常用于重建这些缺陷,但它的有效性取决于骨部件的类型和固定方法.

研究的目的:

为了比较治疗骨骨缺陷的失败率,用morselized allograft与水泥杯,无水泥杯或强化装置相结合.
为了确定植入物失败的主要原因,在修订THA中对大型骨缺陷进行检查.

主要方法:

对从1980年1月到2024年4月发表的研究进行了系统的元分析.
搜索的数据库包括PubMed/MEDLINE,EMBASE和Cochrane系统审查数据库.
主要结局指标是9年植入器失败率,并分析了失败模式.

主要成果:

分析了39篇文章,涵盖了41种治疗方法.
整体9年植入失败率为2.1%,治疗组之间没有显著差异 (水泥杯:1.6%;无水泥杯:2.1%;增强装置:2.5%).
无菌松动是最常见的故障模式 (80.5%),其次是感染 (13.1%) 和脱位 (6.4%). 强化装置与更高的感染率和脱位率有关.

结论:

莫尔塞化整体移植在修复THA中显示出较低的植入失败率,用于大骨缺陷,无论固定方法如何.
虽然整体故障率相似,但加强装置与由于感染和脱位而导致重新修改的风险增加有关.

关键词:

乙骨缺陷是一种缺陷.这就是为什么Hip-Hip-Hip-Hip-Hip-Hip.莫尔塞化的整体移植.

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