Poss R, Maloney J P, Ewald F C, Thomas W H, Batte N J, Hartness C, Sledge C B
Clin Orthop Relat Res. 1984 Jan-Feb(182):109-16.
The results of 138 total hip arthroplasties in 98 rheumatoid arthritic patients were reviewed six to 11 years (mean, 7.0 years) after operation. While 96% of the patients were clinically improved as a result of surgery, radiographic analysis suggests that, despite their low functional requirements, this group of patients experiences mechanical loosening and failure with time. Improvements in prosthetic design and cementing technique should contribute to a lowered incidence of mechanical failure in the future. In addition to improvements in technology, the failure rate can be further diminished by recognition of the systemic problems associated with rheumatoid arthritis, e.g., high incidence of infection, osteopenia, and sequelae of multiple joint involvement. In reconstruction of the acetabulum, especially in the presence of protrusio, failure to restore the anatomic position and orientation of the acetabulum predisposes to loosening and migration.
对98例类风湿性关节炎患者行138例全髋关节置换术的结果进行了回顾，时间为术后6至11年（平均7.0年）。虽然96%的患者术后临床症状得到改善，但影像学分析表明，尽管该组患者功能需求较低，但随着时间推移仍会出现机械性松动和失败。假体设计和骨水泥技术的改进应有助于未来降低机械性失败的发生率。除了技术改进外，认识到与类风湿性关节炎相关的全身性问题，如感染发生率高、骨质减少以及多关节受累的后遗症，可进一步降低失败率。在髋臼重建中，尤其是存在髋臼内陷时，未能恢复髋臼的解剖位置和方向易导致松动和移位。
