Reflor H J, Wirth C J, Schreiner B
Z Orthop Ihre Grenzgeb. 1979 Oct;117(5):724-30.
30 patients whose total endoprosthesis of the hip joint had been removed without any replacement, thus creating a so-called state of secondary resection, were followed up 6 months to 6 years after the operation. It was found that in almost two-thirds of the cases a subjective feeling of improved mobility was reported. The objective findings consisted in restrictions of the total rotation, abduction and adduction of 1/3 rd of the normal extent of mobility. An average value of 74.7 degrees was recorded for flexion. 28 patients stated that their walking performance was satisfactory to very good when using a walking-stick as support. More than three-quarters of the patients questioned stated their pain had been positively influenced by the creation of the state of secondary resection. Another objective finding was a difference between the length of the legs amounting to 4.2 cm on the average. We could prove the existence of a relationship between the difference in leg length and the roentgenologically visualised supporting of the resection area of the coxal end of the femur at the lateral pelvis. Since all the patients with the exception of two could resume their customary daily routine activities, the state of secondary resection after unsuccessful total endoprosthesis of the hip joint must be considered a reasonably acceptable alternative.
30例髋关节全关节置换术后未进行任何置换而形成所谓二次切除状态的患者，在术后6个月至6年进行了随访。结果发现，几乎三分之二的病例报告主观感觉活动能力有所改善。客观检查结果包括总旋转、外展和内收活动度受限，仅为正常活动范围的三分之一。屈曲平均角度记录为74.7度。28例患者表示，使用拐杖辅助行走时，行走能力令人满意或非常好。超过四分之三的受访患者表示，二次切除状态对他们的疼痛产生了积极影响。另一个客观发现是双腿长度平均相差4.2厘米。我们能够证明腿长差异与骨盆外侧股骨髋臼端切除区域在X线片上显示的支撑之间存在关联。由于除两名患者外，所有患者都能恢复日常习惯活动，因此髋关节全关节置换失败后的二次切除状态必须被视为一种合理可接受的替代方案。
