Department of Trauma and Orthopaedics, Sandwell General Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Lyndon, West Bromwich B71 4HJ, UK.
Postgrad Med J. 2011 Feb;87(1024):101-9. doi: 10.1136/pgmj.2009.095620. Epub 2010 Nov 7.
In 2006 over 55,000 primary total hip replacements were implanted in the UK. A crucial aspect of follow-up for these patients is the assessment of the postoperative radiograph. Information gained from the initial radiograph includes assessment of the quality of implantation and hence the likelihood of long term success. Follow-up radiographs can be assessed for signs of component failure. Orthopaedic surgeons, radiologists, junior surgical trainees, general medical practitioners, and advanced nurse/extended scope practitioners may all be required to interpret these radiographs during clinical practice. The authors feel that certainly during orthopaedic surgical training, not enough time is allocated to formal training on the systematic assessment of such radiographs. This review aims to provide the reader with a systematic approach to analysing the initial postoperative total hip arthroplasty radiograph, and subsequent follow-up films. Basics of patient positioning for obtaining radiographs, types of prosthesis encountered, and terminology used are covered. Assessment of initial radiographs focuses on assessing leg length, acetabular and femoral positioning, and cement mantle adequacy. Follow-up radiographs are assessed for signs of component failure. A review of the literature provides evidence for the assessment and importance of adequacy of component positioning, and good cementing technique. Normal and abnormal follow-up radiographic features are outlined to allow assessment of loosening or impending failure of a prosthesis.
2006 年，英国有超过 55000 例初次全髋关节置换术。对这些患者进行随访的一个关键方面是评估术后 X 光片。从初始 X 光片中获得的信息包括对植入物质量的评估，从而评估长期成功的可能性。随访 X 光片可评估部件故障的迹象。骨科医生、放射科医生、初级外科受训者、普通内科医生和高级护士/扩展范围从业者在临床实践中都可能需要解释这些 X 光片。作者认为，在骨科手术培训期间，确实没有分配足够的时间进行此类 X 光片系统评估的正式培训。本综述旨在为读者提供一种系统的方法来分析初次全髋关节置换术后 X 光片和随后的随访片。涵盖了获得 X 光片时患者体位的基本原理、遇到的假体类型和使用的术语。初始 X 光片的评估侧重于评估腿长、髋臼和股骨位置以及水泥覆盖层的充足性。随访 X 光片评估部件故障的迹象。对文献的回顾提供了评估和充分性的证据组件定位和良好的粘合技术。概述了正常和异常的随访 X 光特征，以允许评估假体松动或即将失效。
