Maloney W J, Davey J R, Harris W H
Orthopaedic Biomechanics Lab, Massachusetts General Hospital, Boston.
Clin Orthop Relat Res. 1992 Aug(281):112-4.
Beaded porous-coated implants are commonly used in total joint arthroplasty. In this study, the authors extended the follow-up period for the Davey and Harris study of bead loosening in beaded cementless acetabular components. When 56 primary total hip arthroplasties were first reviewed, at an average of 2.5 years after surgery, the incidence of bead loosening was 8.9%. Reevaluation at a mean of 4.5 years after surgery revealed that the incidence of loosening had increased to 19.6%. Bead loosening was associated with acetabular migration in one component and a broken screw in a second. In the absence of loose beads, there were no broken fixation screws or socket migration. Radiolucencies at the bone-implant interface were seen in association with loose beads in only one case. Although long-term implications of bead loosening are not clear, bead migration may increase the possibility of macrophage response to metallic debris.
带珠多孔涂层植入物常用于全关节置换术。在本研究中，作者延长了Davey和Harris关于带珠非骨水泥髋臼组件中珠子松动研究的随访期。首次对56例初次全髋关节置换术进行评估时，平均术后2.5年，珠子松动的发生率为8.9%。术后平均4.5年重新评估发现，松动发生率已增至19.6%。一个组件中的珠子松动与髋臼移位有关，另一个组件中的一颗螺钉断裂。在没有珠子松动的情况下，没有固定螺钉断裂或髋臼移位。仅在1例中观察到骨-植入物界面的透亮区与珠子松动有关。虽然珠子松动的长期影响尚不清楚，但珠子迁移可能会增加巨噬细胞对金属碎屑反应的可能性。
