Cornell C N, Salvati E A, Pellicci P M
Orthop Clin North Am. 1985 Oct;16(4):757-69.
Patients with osteonecrosis who undergo total hip replacement experience an overall failure rate four times greater than that of patients with osteoarthritis who undergo the procedure. Different etiologic factors associated with osteonecrosis appear to carry different prognoses for the durability of total hip replacements. In addition to discouraging total hip replacement in patients under 30 to 40 years of age and making all possible efforts at reduction of the patient's weight and activity, improvement of bone quality, surgical and cementing techniques, prosthetic design, and materials will prolong the durability of total hip replacement. Despite the inferior long-term results of total hip replacement performed for advanced osteonecrosis, we believe the procedure should not be abandoned for patients in their fifth decade or older because it provides a painless, functional hip more consistently than any other form of arthroplasty. These patients should be informed about the importance of protecting the hip replacement by avoiding strenuous activities, impact, and obesity and about the possibilities of future mechanical failure, requiring revision surgery.
接受全髋关节置换术的骨坏死患者的总体失败率是接受该手术的骨关节炎患者的四倍。与骨坏死相关的不同病因似乎对全髋关节置换术的耐用性有不同的预后。除了不鼓励30至40岁以下的患者进行全髋关节置换术，并尽一切可能减轻患者体重和活动量外，改善骨质量、手术和骨水泥技术、假体设计及材料将延长全髋关节置换术的耐用性。尽管晚期骨坏死患者接受全髋关节置换术的长期效果较差，但我们认为，对于50岁及以上的患者，该手术不应被放弃，因为与任何其他形式的关节成形术相比，它能更持续地提供无痛、功能良好的髋关节。应告知这些患者通过避免剧烈活动、撞击和肥胖来保护髋关节置换的重要性，以及未来可能出现机械故障而需要翻修手术的可能性。
