Zimlich R H, Fehring T K
Charlotte Orthopaedic Research Institute, North Carolina, USA.
J Arthroplasty. 2000 Sep;15(6):796-801. doi: 10.1054/arth.2000.4330.
Periacetabular osteolysis is recognized as a complication of cementless total hip arthroplasty. Routine follow-up radiographs are recommended by most joint reconstructive surgeons to detect osteolytic lesions that may remain asymptomatic. These studies usually consist of an anteroposterior (AP) pelvic and lateral radiograph of the hip. Three male cadaver pelves were used to evaluate whether a routine AP pelvic radiograph was adequate to show certain osteolytic lesions. This study involved creation of progressively enlarging defects simulating an osteolytic lesion of the posterior wall. The extent of involvement of the lesion as shown by an AP pelvic radiograph and iliac oblique views was then compared. By the time the posterior column lesion could be estimated to the same extent on both the AP pelvic and iliac oblique radiographs, the lesion had become uncontained in the posterior medial direction. The evaluation of pelvic osteolysis with biplanar imaging provides a 3-dimensional understanding of the lesion. This study shows the inadequacy of a single AP pelvic radiograph in showing and localizing periprosthetic osteolytic lesions in the posterior column.
髋臼周围骨溶解被认为是无水泥型全髋关节置换术的一种并发症。大多数关节重建外科医生建议进行常规随访X线片检查，以检测可能无症状的骨溶解病变。这些检查通常包括骨盆前后位（AP）和髋关节侧位X线片。使用三具男性尸体骨盆来评估常规AP骨盆X线片是否足以显示某些骨溶解病变。本研究涉及创建逐渐扩大的缺损，模拟后壁的骨溶解病变。然后比较AP骨盆X线片和髂骨斜位片所示病变的累及范围。当骨盆前后位和髂骨斜位X线片上的后柱病变能够被估计到相同程度时，病变已向后方内侧失去包绕。用双平面成像评估骨盆骨溶解可对病变有三维的理解。本研究表明，单一的AP骨盆X线片在显示和定位后柱假体周围骨溶解病变方面存在不足。
