Engelbrecht E, Siegel A
Endo-Klinik, Hamburg.
Radiologe. 1989 Oct;29(10):508-18.
Complications seen after long-term follow-up examinations of total hip replacement should be treated immediately and completely. In the past decade a considerable increase in revisions has been noted. Radiographic assessment may be regarded as an effective means in diagnosing prosthetic complications from the surgeon's point of view. Examples are given. The difficulties in radiographic assessment of complications after cementless implantation or cemented prostheses without contrast media are mentioned. Prosthesis-related complications, such as mechanical loosening, infection with and without loosening, fatigue fractures and wear, fractures of the femur or pelvis, dislocations and surgical failures, are illustrated, as are clinical courses with gross loss of bone stock after repeated surgery and delayed revisions. Complications not related to the prosthesis such as periarticular ossification, muscle deficiencies, and nervous and vascular lesions are also explained using examples.
全髋关节置换长期随访检查中出现的并发症应立即得到彻底治疗。在过去十年中，翻修手术数量显著增加。从外科医生的角度来看，影像学评估可被视为诊断假体并发症的有效手段。文中给出了实例。还提到了在无造影剂的情况下对非骨水泥植入或骨水泥假体术后并发症进行影像学评估的困难。文中阐述了与假体相关的并发症，如机械性松动、有无松动的感染、疲劳骨折和磨损、股骨或骨盆骨折、脱位及手术失败，以及多次手术后骨量大量丢失和延迟翻修的临床过程。文中还通过实例解释了与假体无关的并发症，如关节周围骨化、肌肉缺陷以及神经和血管病变。
