Shah Siddharth M
S L Raheja (A Fortis Associate) hospital, Mahim West, Mumbai, India.
J Orthop. 2019 Oct 9;16(6):A1-A3. doi: 10.1016/j.jor.2019.10.001. eCollection 2019 Nov-Dec.
The femoral head size influences dislocation, range of motion (ROM), functional outcome, wear, and survival after total hip arthroplasty (THA). These aspects of different head sizes with contemporary bearings in primary THA have been reviewed. Based on the existing evidence, for highly-cross-linked polyethylene (HXLPE) bearings, a 32 mm cobalt chromium (CoCr) or ceramic head appears to be a suitable choice. If a 36 mm head with HXLPE is desired, a ceramic head may be preferable over CoCr due to reduced risk of fretting and corrosion with the former. For ceramic-on-ceramic (CoC) bearings, head sizes >36 mm do not appear to provide any significant benefit over 36 mm heads. Also, large ceramic heads may lead to increased risk of squeaking. If non-cross-linked PE bearing is considered for use, it would be prudent to opt for <32 mm head size.
股骨头大小会影响全髋关节置换术（THA）后的脱位、活动范围（ROM）、功能结果、磨损及假体生存率。本文回顾了初次THA中不同尺寸股骨头与当代关节轴承相关的这些方面。基于现有证据，对于高交联聚乙烯（HXLPE）轴承，32毫米钴铬（CoCr）或陶瓷股骨头似乎是合适的选择。如果需要使用36毫米的HXLPE股骨头，由于陶瓷股骨头的微动和腐蚀风险较低，可能比CoCr股骨头更可取。对于陶瓷对陶瓷（CoC）轴承，大于36毫米的股骨头尺寸似乎并不比36毫米的股骨头有任何显著优势。此外，大尺寸陶瓷股骨头可能会增加 squeaking 的风险。如果考虑使用非交联聚乙烯轴承，选择小于32毫米的股骨头尺寸较为谨慎。
