Williams R P, McQueen D A
University of Kansas School of Medicine-Wichita.
Clin Orthop Relat Res. 1992 Feb(275):174-9.
Eighteen patients being treated for revision total hip arthroplasty for aseptic loosening an average of 9.5 years after primary cemented hip arthroplasty were studied. The patients were found to have been symptomatic an average of one year before revision. Review of the roentgenograms at the time of revision revealed that most patients had moderate to severe loosening of the prostheses by Charnley's criteria. These findings were confirmed at surgery. Study of the tissue surrounding the prostheses suggests that the prominent particles were methylmethacrylate "pearls" caused by cement fragmentation. These particles were surrounded by histiocytes that were actively synthesizing and releasing protein. Cement fragmentation and not polyethylene wear may be the major cause of late aseptic loosening of cemented hip prostheses.
对18例因无菌性松动而接受翻修全髋关节置换术的患者进行了研究，这些患者在初次骨水泥型髋关节置换术后平均9.5年出现症状。发现这些患者在翻修前平均有一年的症状。翻修时对X线片的复查显示，根据Charnley标准，大多数患者的假体有中度至重度松动。这些发现已在手术中得到证实。对假体周围组织的研究表明，突出的颗粒是由骨水泥碎裂产生的甲基丙烯酸甲酯“珠粒”。这些颗粒被正在活跃合成和释放蛋白质的组织细胞所包围。骨水泥碎裂而非聚乙烯磨损可能是骨水泥型髋关节假体晚期无菌性松动的主要原因。
