Sports and Medicine Unit, North Lille University, 59000 Lille, France.
Orthop Traumatol Surg Res. 2011 Apr;97(2):121-6. doi: 10.1016/j.otsr.2010.10.006. Epub 2011 Mar 23.
Secondary subsidence of a revision femoral stem is often a negative predictive sign for successful osseointegration and perfect long-term stability.
We performed a retrospective study in a series of 183 revision total hip replacements between 1996 and 2000 to evaluate the importance and risk factors of secondary subsidence with a cementless press-fit design femoral stem as well as this subsidence's consequences to osseointegration.
Secondary subsidence did not occur in 80 cases (53%), was between 0 and 4mm in 41 cases (27%); between 5 and 10mm in 17 cases (12%) and was greater than 10mm in 12 cases (8%). Mean subsidence of all patients was 3mm (0-30). There was a statistically significant negative correlation between subsidence and the quality of osseointegration (P=0.03). There was no significant relationship between component diameter and stem subsidence (P=0.9). The presence of preoperative bone deficiencies did not increase the risk of secondary subsidence (P=0.2).
In the case of revision with press-fit stems, the importance of secondary subsidence should not be overestimated, because it usually does not negatively affect satisfactory osseointegration.
翻修股骨柄的二次下沉通常是骨整合成功和长期稳定性良好的负面预测标志。
我们对 1996 年至 2000 年间的 183 例翻修全髋关节置换术进行了回顾性研究，以评估无水泥压配设计股骨柄的二次下沉的重要性和危险因素，以及这种下沉对骨整合的影响。
80 例（53%）无二次下沉，41 例（27%）下沉在 0 至 4mm 之间，17 例（12%）下沉在 5 至 10mm 之间，12 例（8%）下沉大于 10mm。所有患者的平均下沉量为 3mm（0-30）。下沉与骨整合质量之间存在显著的负相关（P=0.03）。组件直径与柄下沉之间无显著关系（P=0.9）。术前骨缺损的存在并不能增加二次下沉的风险（P=0.2）。
在压配式翻修中，不应过分高估二次下沉的重要性，因为它通常不会对满意的骨整合产生负面影响。
