Butler J C, Skalley T C, Cook S D, Brinker M R, Haddad R J, Sackett J R, Cheramie J B
Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana 70112.
Clin Orthop Relat Res. 1990 May(254):180-8.
Fifty-six DePuy anatomic medullary locking femoral bipolar prostheses were reviewed clinically and roentgenographically in 50 patients at an average follow-up period of 30 months (range, 24-71 months). Forty-four of the implantations were in 40 male and 12 were in ten female patients. Forty-five devices were placed in primary operations, while 11 were used in revisions. The overall average age was 53.5 years. The average Harris hip scores for the primary bipolars were 29.8 preoperative and 77.3 postoperative, while the revision bipolars had Harris hip scores of 35.9 preoperative and 75.1 postoperative. Nearly one-half (47%) of all primary and 54% of the revision patients experienced pain to some degree on ambulation. Roentgenographically, all femoral components appeared to be well fixed biologically. Roentgenographic changes occurred with time in both primary and revision prostheses. On roentgenographic zonal analysis of primary prostheses, radiolucencies greater than 1 mm were present most frequently in the most proximal lateral zone and at the distal tip of the prosthesis. Although the use of noncemented bipolar prostheses generally shows acceptable clinical results, noncemented fixed acetabular components with noncemented femoral components produce a more satisfactory clinical result.
对50例患者的56个DePuy解剖型髓内锁定股骨双极假体进行了临床和影像学回顾，平均随访时间为30个月（范围24 - 71个月）。44个假体植入40名男性患者，12个假体植入10名女性患者。45个假体用于初次手术，11个用于翻修手术。总体平均年龄为53.5岁。初次双极假体术前Harris髋关节评分平均为29.8分，术后为77.3分，而翻修双极假体术前Harris髋关节评分为35.9分，术后为75.1分。几乎一半（47%）的初次手术患者和54%的翻修手术患者在行走时都有不同程度的疼痛。影像学检查显示，所有股骨部件在生物学上似乎固定良好。初次和翻修假体的影像学表现均随时间发生变化。对初次假体进行影像学分区分析时，大于1mm的透亮区最常出现在最近端外侧区域和假体远端尖端。虽然使用非骨水泥双极假体通常显示出可接受的临床结果，但非骨水泥固定髋臼部件与非骨水泥股骨部件结合能产生更满意的临床结果。
