von Knoch M, Engh C A, Sychterz C J, Engh C A, Willert H G
Orthopaedic University Hospital, Goettingens, Germany.
J Arthroplasty. 2000 Jan;15(1):72-8. doi: 10.1016/s0883-5403(00)91259-2.
This autopsy study analyzed the migration of polyethylene wear debris adjacent to uncemented femoral components with circumferential porous coating. Five femoral specimens retrieved at autopsy from 3 patients were investigated. Two stems were 40% porous coated, 2 were 80% porous coated, and 1 was 100% porous coated. The implants' time in situ ranged from 53 to 132 months (average, 94.8 months). All patients were followed clinically and radiographically until death. Radiographically, 3 of the stems were bone ingrown with proximal bone loss, 1 stem was mainly fibrous encapsulated, and 1 stem was completely fibrous encapsulated. Histologic examination of bone adjacent to the middle and distal sections of the femoral implant revealed no polyethylene wear debris or granulation tissue in any of the specimens. In 2 bone-ingrown cases, a small number of polyethylene particles and small areas of granulation tissue were present at the proximal level. This granulation tissue, however, did not cause major osteolysis. The findings in this study imply that circumferential porous coating of cementless femoral components could prevent distal migration of polyethylene wear debris along the bone-implant interface in both bone-ingrown and fibrous-encapsulated femoral implants.
这项尸检研究分析了带有周向多孔涂层的非骨水泥型股骨假体周围聚乙烯磨损颗粒的迁移情况。对从3例患者尸检中获取的5个股骨标本进行了研究。2个股骨柄的多孔涂层覆盖率为40%，2个股骨柄为80%，1个股骨柄为100%。植入物在体内的时间为53至132个月（平均94.8个月）。所有患者均接受临床和影像学随访直至死亡。影像学检查显示，3个股骨柄有骨长入且近端有骨质流失，1个股骨柄主要被纤维组织包裹，1个股骨柄完全被纤维组织包裹。对股骨植入物中、远端相邻骨组织的组织学检查发现，所有标本中均未发现聚乙烯磨损颗粒或肉芽组织。在2例骨长入的病例中，近端有少量聚乙烯颗粒和小面积肉芽组织。然而，这种肉芽组织并未引起严重的骨溶解。本研究结果表明，非骨水泥型股骨假体的周向多孔涂层可防止聚乙烯磨损颗粒在骨长入型和纤维包裹型股骨植入物中沿骨-植入物界面向远端迁移。
