Vázquez-Vela E, Vázquez-Vela G
Department of Orthopaedics, Hospital General Dr. Manuel Gea Gonzalez, Mexico City.
Clin Orthop Relat Res. 1990 Feb(251):87-91.
The Bateman bipolar prosthesis has been used by the authors since 1974. The purpose of this study is to determine whether the implant functions as a bipolar device or as a unipolar hemiarthroplasty, which may cause damage to the acetabulum. Of 478 hips replaced from 1973 to 1983, 19 with acetabular changes were randomly selected to evaluate the response of the prosthesis. From the 11 cases with protrusio at the time of surgery, six showed thickening of the acetabular wall, while no changes were observed during ten years follow-up study in the five remaining cases; in one case, the wall gave way, and a revision was necessary. In five patients with subchondral cysts, the cysts tended to gradually disappear. Three patients showed sclerosis in the subchondral acetabular bone, which also decreased gradually. Previous facts suggest the acetabulum tolerates the implant well even with some damage at the time of surgery. Whether this depends on the amount of movement and friction occurring between the head and the insert is still undetermined.
自1974年起，作者们就开始使用贝特曼双极假体。本研究的目的是确定该植入物是作为双极装置发挥作用，还是作为可能会对髋臼造成损伤的单极半关节置换术发挥作用。在1973年至1983年间接受髋关节置换的478例患者中，随机选取了19例出现髋臼变化的患者来评估假体的反应。在手术时有髋臼突出的11例患者中，6例显示髋臼壁增厚，而其余5例在十年的随访研究中未观察到变化；其中1例髋臼壁出现破损，需要进行翻修手术。在5例有软骨下囊肿的患者中，囊肿有逐渐消失的趋势。3例患者髋臼软骨下骨出现硬化，也逐渐减轻。既往事实表明，即使在手术时有一定损伤，髋臼对植入物的耐受性也良好。这是否取决于股骨头与髋臼内衬之间产生的运动量和摩擦力仍未确定。
