Pazzaglia U E, Ghisellini F, Barbieri D, Ceciliani L
Clinica Ortopedica e Traumatologica dell'Università di Pavia, IRCCS Policlinico San Matteo, Italy.
Arch Orthop Trauma Surg (1978). 1988;107(4):195-202. doi: 10.1007/BF00449667.
Thirteen failed stem of Total Hip Replacement were studied: 9 were Charnley THR from an homogeneous series, which gives an incidence of 2.4% of stem fractures with a follow-up of 9-16 years; 4 were Mueller THR. Fatigue fracture of the stem occurred by defective support of the proximal part of the femur, following resorption of the calcar. In all cases reactive tissue to foreign body particles, metal and polyethylene, was found where bone resorption occurred. In Mueller THR wear of the cup produced the large amount of polyethylene particles; in Charnley THR metal particles prevailed and corrosion of the stem is suggested to be the initiating factor.
对13例全髋关节置换术失败的股骨柄进行了研究：9例为同一组的Charnley全髋关节置换术，随访9至16年，股骨柄骨折发生率为2.4%；4例为Mueller全髋关节置换术。股骨柄的疲劳骨折是由于股骨近端支持不足，股骨距吸收所致。在所有骨吸收发生的病例中，均发现了对异物颗粒（金属和聚乙烯）的反应性组织。在Mueller全髋关节置换术中，髋臼杯的磨损产生了大量聚乙烯颗粒；在Charnley全髋关节置换术中，金属颗粒占主导，提示股骨柄的腐蚀是起始因素。
