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[全髋关节置换术中颗粒疾病的诊断与治疗]

[Diagnosis and therapy of particle disease in total hip arthroplasty].

作者信息

Müller M, Wassilew G, Perka C

机构信息

Centrum für Muskuloskeletale Chirurgie, Klinik für Orthopädie/Klinik für Unfall- und Wiederherstellungschirurgie, Charité - Universitätsmedizin Berlin.

出版信息

Z Orthop Unfall. 2015 Apr;153(2):213-29. doi: 10.1055/s-0035-1545827. Epub 2015 Apr 14.

Abstract

Particle disease is caused by periarticular accumulation of attrition particles and the inflammatory reaction of the body's tissue. This process may result in osteolysis or soft tissue transformation which presents itself symptomless in the beginning and can proceed to aseptic implant loosening, fracture, implant breaking as a result of the inappropriate osseous support and to algetic and destructive soft tissue reactions as well. Attrition particles originate from tribological pairing, and the extent of the attrition or the particle concentration depend on different factors as there are the tribological pairing's material, the head size, the patient's level of activity, and the implant position. Attrition particles can also be found in the range of any modular connection. Particle disease and its resulting morphological alterations of the tribological pairing is one of the most frequent reasons for re-operation in hip endoprosthetics.

摘要

颗粒病是由关节周围磨损颗粒的积聚以及身体组织的炎症反应引起的。这个过程可能导致骨溶解或软组织改变,起初并无症状,随后可能因骨支撑不当而导致无菌性植入物松动、骨折、植入物断裂,以及引发疼痛性和破坏性的软组织反应。磨损颗粒源自摩擦副,磨损程度或颗粒浓度取决于不同因素,如摩擦副材料、头部尺寸、患者的活动水平以及植入物位置。在任何模块化连接部位都能发现磨损颗粒。颗粒病及其导致的摩擦副形态改变是髋关节置换术中再次手术最常见的原因之一。

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