Kavanagh B F, Fitzgerald R H
Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905.
J Bone Joint Surg Am. 1987 Oct;69(8):1144-9.
Forty-five patients (forty-five hips) underwent repeat revisions of a total hip arthroplasty that had failed but was not associated with infection; seven of these patients had a third revision. The mean length of follow-up was approximately three years, and no patients were lost to follow-up. Twenty-eight of the forty-five patients had no or slight pain after the second revision, and thirty reported that their condition was improved. After the third revision, six patients had no or only slight pain, and five said that their condition was improved. On final roentgenographic examination, there was probable loosening (migration or subsidence of a component, lucency at the prosthesis-cement interface, fracture of the cement, or complete radiolucency at the bone-cement, or complete radiolucency at the bone-cement interface of more than one millimeter in at least one zone) of eight of the acetabular components and thirteen of the femoral components after the second revision and three acetabular components and one femoral component after the third. There was symptomatic loosening (moderate or severe pain and probable roentgenographic loosening) in six patients after the second revision and one after the third. Significant postoperative complications were noted in nineteen of the forty-five patients, and treatment was considered to be a failure in eleven hips after the second revision and in two after the third.
45例患者（45髋）接受了失败但无感染的全髋关节置换翻修术；其中7例患者进行了第三次翻修。平均随访时间约为3年，无患者失访。45例患者中，28例在第二次翻修后无疼痛或仅有轻微疼痛，30例报告病情改善。第三次翻修后，6例患者无疼痛或仅有轻微疼痛，5例称病情改善。在最后一次X线检查时，第二次翻修后8个髋臼组件和13个股骨组件可能出现松动（组件移位或下沉、假体 - 骨水泥界面透亮、骨水泥骨折或骨 - 骨水泥界面至少一个区域出现超过1毫米的完全透亮），第三次翻修后3个髋臼组件和1个股骨组件出现松动。第二次翻修后6例患者出现有症状的松动（中度或重度疼痛且X线检查可能松动），第三次翻修后1例出现。45例患者中有19例出现明显的术后并发症，第二次翻修后11髋和第三次翻修后2髋的治疗被认为失败。
