Retpen J B, Jensen J S
University of Copenhagen, Department of Orthopedics, Rigshospitalet, Denmark.
J Arthroplasty. 1993 Oct;8(5):471-8.
A series of 160 consecutive cemented first revisions, performed from 1977 through 1988 for aseptic loosening of a primary cemented femoral component, were studied using survivorship methods with the purpose of identifying risk factors for recurrent loosening of the femoral component. Risk of recurrent loosening depended on the length of the revision stem, with a significantly increased risk of loosening if the tip of the primary stem was overbridged by the revision stem with less than one width of the femoral shaft. Risk of recurrent loosening was also related to the extension of a cement mantle, exceeding more than 2 mm, around the revision stem measured on postrevision anteroposterior radiographs. Furthermore, low age and neutral position of the revision stem were identified as risk factors for recurrent loosening of the cemented revision femoral component. An improved fixation of the cemented revision femoral component for revisions performed after 1982 could be related to the use of longer revision stems and improved cementation.
对1977年至1988年期间因初次骨水泥固定股骨假体无菌性松动而进行的160例连续骨水泥翻修手术进行了研究，采用生存分析方法以确定股骨假体再次松动的危险因素。再次松动的风险取决于翻修柄的长度，如果初次柄的尖端被翻修柄跨越的股骨宽度小于一个宽度，则松动风险显著增加。再次松动的风险还与翻修术后前后位X线片上测量的翻修柄周围骨水泥套超过2mm的延伸有关。此外，低龄和翻修柄的中立位被确定为骨水泥翻修股骨假体再次松动的危险因素。1982年后进行的骨水泥翻修股骨假体固定的改善可能与使用更长的翻修柄和改进的骨水泥固定有关。
