Heck D A, Chao E Y, Sim F H, Pritchard D J, Shives T C
Clin Orthop Relat Res. 1986 Mar(204):266-85.
Thirteen patients with titanium fibermetal segmental bone/joint prostheses at a minimum follow-up period of six months were reviewed. Detailed radiographic data were analyzed quantitatively in terms of stem/bone interface radiolucency and bone bridging over the segmental portion of the prosthesis at predefined zones. Although stem radiolucent lines were common in this series, only one case had clinical loosening and required reoperation. There were two cases of stem fracture; one achieved extracortical bone union without revision, and the other case required implant removal and revision. Analysis of the retrieved specimen revealed histologic evidence of bony ingrowth. The use of a long side plate for initial implant fixation might have been partially responsible for this complication because of inhibition of new bone formation over the porous-coated segment. Sequential study of radiograms at different follow-up time periods with the same zonal analysis criteria revealed that no progression of radiolucency occurred at the bone/prosthesis interface, and bone formation over the segmental portion either increased or stabilized with time. The patients' functional results and implant performance seemed to indicate that the porous-coated segmental prosthetic system was effective in bridging skeletal/joint defects. However, further improvements are needed in prosthetic design and implant quality control in order to minimize device-related complications.
对13例使用钛纤维金属节段性骨/关节假体且随访期至少为6个月的患者进行了回顾性研究。根据柄/骨界面的透射线情况以及在假体节段部分预定义区域的骨桥接情况，对详细的影像学数据进行了定量分析。尽管在该系列中柄部透射线较为常见，但只有1例出现临床松动并需要再次手术。有2例柄部骨折；1例在未进行翻修的情况下实现了皮质外骨愈合，另1例则需要取出植入物并进行翻修。对取出标本的分析显示有骨长入的组织学证据。最初使用长侧板进行植入物固定可能是导致该并发症的部分原因，因为它抑制了多孔涂层节段上的新骨形成。采用相同的分区分析标准对不同随访时间段的X线片进行连续研究发现，骨/假体界面处的透射线没有进展，节段部分的骨形成随时间增加或稳定。患者的功能结果和植入物性能似乎表明，多孔涂层节段性假体系统在桥接骨骼/关节缺损方面是有效的。然而，为了尽量减少与器械相关的并发症，假体设计和植入物质量控制仍需进一步改进。
