Brand R A, Pedersen D R, Yoder S A
Clin Orthop Relat Res. 1986 Sep(210):185-91.
Loosening is the most common long-term problem following total hip reconstruction. For many reasons, it is important to identify the loosened total hip reconstruction. For some purposes, radiographic interpretation is the sole or principal determinant in loosening. However, there are inherent problems with such interpretations, and these problems have neither been explored in any detail in the literature nor emphasized. This article is a review of the literature and one of the problems of defining loosening. Interpretations of radiographic criteria of loosening are matters of judgment, but this judgment is not reflected in the descriptions of precisely how radiographs were interpreted. Definitions in the literature, based on lucencies and position changes, influenced the loosening rate by a factor of at least two, and influenced the apparent importance of risk factors affecting the long-term results by as much as two to three times. Thus by merely altering a definition one can alter which factors seem more or less important. The selection of a definition of loosening must be designed to a specific purpose, but data and a rationale should be provided as a basis for its interpretation. In general, descriptions of radiograph interpretation need to be precise and less subjective.
松动是全髋关节置换术后最常见的长期问题。出于多种原因，识别松动的全髋关节置换物很重要。对于某些目的而言，影像学解释是判断松动的唯一或主要决定因素。然而，这种解释存在一些固有问题，这些问题在文献中既未得到详细探讨，也未受到重视。本文是一篇文献综述，也是关于定义松动的问题之一。对松动的影像学标准的解释是判断问题，但这种判断并未体现在关于如何精确解读X线片的描述中。文献中基于透亮区和位置变化的定义，使松动率至少相差两倍，并使影响长期结果的危险因素的明显重要性相差两到三倍。因此，仅仅改变一个定义就可以改变哪些因素看起来更重要或不太重要。松动定义的选择必须针对特定目的进行设计，但应提供数据和理论依据作为其解释的基础。一般来说，X线片解释的描述需要精确且主观性更低。
