Cook S D, Thomas K A, Barrack R L, Whitecloud T S
Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana 70112-2699.
Clin Orthop Relat Res. 1992 Oct(283):163-70.
Histologic examination was performed on 42 uncemented, porous-coated acetabular components removed for reasons not related to fixation. Included were 20 devices that had fixed pegs or spikes to aid in initial fixation and 22 devices that used screws through the component. The diagnoses and patient ages at insertion, times in situ, and reasons for removal were comparable for the two groups. Bone ingrowth was observed in 28 of the 42 acetabular components (67%). Of the 20 components with pegs or spikes, nine had no bone ingrowth, six had minimal bone ingrowth, four had moderate ingrowth, and one had extensive bone ingrowth. Of the 22 components with screws, five had no bone ingrowth, six had minimal bone ingrowth, six had moderate bone ingrowth, and five had extensive bone ingrowth. Two of the devices with screws also had external threads on the metallic shell; neither had any bone ingrowth, and the two accounted for two of the five devices having no bone ingrowth in this group. Bone ingrowth occurred more frequently, in greater amounts and was more evenly distributed anatomically in cups using screws for initial adjunct fixation. Roentgenographic and clinical findings were unreliable in predicting ingrowth of bone.
对42个因与固定无关的原因而取出的非骨水泥型多孔涂层髋臼部件进行了组织学检查。其中包括20个带有固定钉或尖刺以辅助初始固定的装置，以及22个通过部件使用螺钉的装置。两组的诊断、植入时的患者年龄、在位时间和取出原因具有可比性。42个髋臼部件中有28个（67%）观察到骨长入。在20个带有钉或尖刺的部件中，9个没有骨长入，6个有少量骨长入，4个有中度骨长入，1个有广泛骨长入。在22个带有螺钉的部件中，5个没有骨长入，6个有少量骨长入，6个有中度骨长入，5个有广泛骨长入。两个带有螺钉的装置在金属外壳上也有外螺纹；两者都没有骨长入，这两个装置占该组中5个没有骨长入装置中的两个。在使用螺钉进行初始辅助固定的髋臼杯中，骨长入更频繁、量更大且在解剖学上分布更均匀。X线和临床检查结果在预测骨长入方面不可靠。
