Amstutz H C, Contini R, Johnson R L
Clin Orthop Relat Res. 1975 Jan-Feb(106):131-9.
Three cases are presented and analyzed in which a Lippman Transfixion Hip Prosthesis had to be replaced because of the discomfort of the patient. In each case, there was evidence of wear between the head of the prosthesis and the flange. The different wear patterns indicated problems which exist in the alignment of component parts of the prosthesis. In each case there was low grade sepsis to which the debris may have contributed. Because of phagocytosis, amount of debris accumulation was difficult to evaluate. The factors which appear to have contributed to the amount of debris accumulation were: the length of time the prosthesis had been used; the degree of alignment and amount of debris which may be formed and is phagocytized; the degree of manufacturing control. The design of this prosthesis incorporated mechanical problems which are generally undesirable because of: the eventual deformation of the end of the pivot rod or hole in the head of the prosthesis: progressive loosening of the movement due to this and inherent malalignment; the difficulty in fabrication, assembly and installation of the prosthesis because of the multiplicity of parts; the difficulty in maintaining adequate control of surface finishes.
本文呈现并分析了三例因患者不适而不得不更换利普曼全髋关节假体的病例。在每例病例中，均有假体头部与凸缘之间磨损的证据。不同的磨损模式表明了假体部件对齐方面存在的问题。每例病例中均存在低度感染，碎片可能是导致感染的原因之一。由于吞噬作用，碎片积累量难以评估。似乎导致碎片积累量的因素有：假体使用的时间长度；对齐程度以及可能形成并被吞噬的碎片量；制造控制程度。该假体的设计存在一些机械问题，这些问题通常是不可取的，原因如下：枢轴杆端部或假体头部孔最终会变形；由此导致运动逐渐松动以及固有不对齐；由于部件众多，假体的制造、组装和安装存在困难；难以对表面光洁度进行充分控制。
