인공고관절 재치환술 시 이식한 지지 동종 피질골의 운명

초록

Introduction We evaluate the medium to long-term follow-up results of cortical strut allograft for periprosthetic bone defect about its fate radiologically and its correlation with clinical outcomes. Materials and methods A retrospective study was carried out with 19 patients who used cortical strut allograft for bone defect during revision total hip arthroplasty(THA) due to loosening and infection and augmentation of cortical strut allograft during open reduction and internal fixation(ORIF) for periprosthetic fracture from 2001 to 2015. The mean age was 59.4 years at index operation. The average follow - up was 8.6 years. Nine cases were owing to asceptic loosening, five cases for periprosthetic fractures, five cases for infections. The cases were classified in detail, and the length of allograft and the union period were measured, and the correlation between the length and the detailed classification and union period was analyzed. Clinically The Harris hip score(HHS) and Kaplan-Meier(KM) survivorship were measured at the final follow up. . Results The average length of allograft used in fractured patients significantly longer than revision THA patienrs for aseptic loosening or infection. Of the 19 cases, incorporation was observed in 18 cases (94.7%). The average period was 21.2 months. The average period of incorporation was no significant difference between the two groups. No positive correlation was identified between the length of allograft and incorporation period. No correlation was observed among the incorporation period in the cortical strut allograft, according to the subdivisions of Paprosky and Vancouver. Conclusion Results of cortical strut allograft for periporsthetic bone defects show excellent incorporation in the mid-long term follow-up. The use of cortical strut allograft considered useful for the treatment of femoral bone defects for revision THA and periprosthetic fracture.