Cook S D, Barrack R L, Clemow A J
Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana 70112-2699.
J Bone Joint Surg Br. 1994 Jan;76(1):68-72.
We examined 108 uncemented femoral stems with modular femoral heads which had been retrieved for reasons other than loosening. There were detectable amounts of wear and corrosion in 10 of 29 (34.5%) mixed-alloy components and 7 of 79 (9%) single-alloy components after a mean implantation time of 25 months. We found no correlation between the presence or extent of corrosion or surface damage and any of time in situ, initial diagnosis, reason for removal, age, or weight. Stems with wear and corrosion were less likely to show histological bony ingrowth. The interface between the head and stem of modular total hip components is a possible source of ion release and wear debris, but wear and corrosion were totally absent in most specimens. This suggests that this problem could be avoided, and that further research is required to develop manufacturing methods which would minimise such changes.
我们检查了108个带模块化股骨头的非骨水泥型股骨柄,这些股骨柄因松动以外的原因被取出。平均植入25个月后,29个(34.5%)混合合金部件中有10个以及79个(9%)单一合金部件中有7个出现了可检测到的磨损和腐蚀。我们发现腐蚀或表面损伤的存在与否、程度与原位时间、初始诊断、取出原因、年龄或体重之间均无相关性。有磨损和腐蚀的股骨柄显示出组织学骨长入的可能性较小。模块化全髋关节组件的股骨头与股骨柄之间的界面可能是离子释放和磨损碎屑的来源,但大多数标本中完全没有磨损和腐蚀。这表明这个问题是可以避免的,并且需要进一步研究以开发能够将此类变化降至最低的制造方法。