Winter M, Griss P, Scheller G, Moser T
Department of Orthopedic Surgery, Mannheim Medical School, University of Heidelberg, Germany.
Clin Orthop Relat Res. 1992 Sep(282):73-80.
One hundred total hip arthroplasties with a cementless aluminum oxide socket and ball with different types of cemented metal femoral stems were performed from 1974 to 1979. All were primary implantations. These cases were recently reviewed in a ten- to 14-year follow-up evaluation. Despite extensive laboratory testing of the ceramic material, a significant number of cases resulted in a very unfavorable result such as extensive wear, ball fracture, or migration of the socket. Whereas the patients had died or could no longer be traced in the case of 23 prostheses, there were 25 prostheses that had already been exchanged at the time of review for mechanical reasons (two stem fractures, eight ceramic ball fractures) and for component loosening attributable to wear of the alumina components. The remaining 52 prostheses still in place had good clinical results in 80%. However, roentgenographic evaluation of these prostheses revealed signs of loosening in six femoral components and in three sockets. Migration of more than 5 mm was evident in 24 sockets (46% of surviving prostheses). Although this had caused loosening in only three sockets at the time of review, further migration up to the limits of the acetabular region would be a major reason for future failures.
1974年至1979年期间，共进行了100例全髋关节置换术，采用了无骨水泥的氧化铝髋臼杯和球头，并搭配不同类型的骨水泥型金属股骨柄。所有手术均为初次植入。最近对这些病例进行了10至14年的随访评估。尽管对陶瓷材料进行了广泛的实验室测试，但仍有相当数量的病例出现了非常不理想的结果，如广泛磨损、球头骨折或髋臼杯移位。在23个假体的病例中，患者已死亡或无法再追踪到，在复查时，有25个假体因机械原因（2个股骨柄骨折、8个陶瓷球头骨折）以及氧化铝部件磨损导致的部件松动而已经更换。其余52个仍在位的假体中有80%取得了良好的临床效果。然而，对这些假体的X线评估显示，6个股骨部件和3个髋臼杯出现了松动迹象。24个髋臼杯（占存活假体的46%）有超过5毫米的移位。尽管在复查时只有3个髋臼杯因移位导致了松动，但进一步移位至髋臼区域的极限将是未来失败的主要原因。
