Harris W H
Orthopedic Biomechanics Laboratory, Massachusetts General Hospital, Boston 02114.
Can J Surg. 1995 Feb;38 Suppl 1:S55-60.
Two important new observations underlie the recommendation that it is advisable to cement all femoral components of total hip replacement (THR). First, it is now clear that improved cementing techniques have remarkably extended the durability of the cemented fermoral fixation and markedly reduced the incidence of lysis. Second, the incidence of femoral lysis around all noncemented femoral components that have been reported with minimum 5-year follow-up is high, increasing and alarming. With good cementing in primary THR, the incidence of femoral revision for aseptic loosening at 15 to 18 years after the initial operation is only 2% to 3%, even in those 50 years of age and younger. Moreover, lysis is rare. Similarly, with improved femoral cementing, femoral revision is also far more effective. The juxtaposition of the excellent results with improved cementing and the high and rising lysis rates around noncemented femoral components clearly mandate the use of contemporary cementing procedures for all femoral components, regardless of the age or sex of the patient, the diagnosis and whether the procedure is a primary or revision one.
全髋关节置换术（THR）中建议对所有股骨组件进行骨水泥固定有两个重要的新观察结果作为依据。首先，现在很明显，改进的骨水泥技术显著延长了骨水泥固定股骨的耐久性，并显著降低了骨溶解的发生率。其次，所有报告了至少5年随访的非骨水泥固定股骨组件周围股骨骨溶解的发生率很高，且呈上升趋势，令人担忧。在初次全髋关节置换术中进行良好的骨水泥固定，即使是50岁及以下的患者，初次手术后15至18年因无菌性松动进行股骨翻修的发生率仅为2%至3%。此外，骨溶解很少见。同样，随着股骨骨水泥固定技术的改进，股骨翻修也更有效。骨水泥固定取得的优异结果与非骨水泥固定股骨组件周围不断上升的高骨溶解率形成鲜明对比，这显然要求对所有股骨组件都采用当代骨水泥固定程序，无论患者的年龄、性别、诊断情况以及手术是初次手术还是翻修手术。
