Sprick O, Dufek P
Klinik für Orthopädie, Medizinischen Universität zu Lübeck.
Z Orthop Ihre Grenzgeb. 1993 Nov-Dec;131(6):524-31. doi: 10.1055/s-2008-1040065.
We reviewed 138 primary arthroplasties performed until March 31, 1986 clinically and radiographically. They were followed up for an average of 76 months (60 to 102). 125 (90.6%) hips could be classified as very good/good, 8 (5.8%) as fair and 5 (3.6%) as poor. The average preoperative Harris hip score was 43.6 (12.61) points and the average 6-year score was 91.2 (63-100) points. Two years after implantation, thigh pain associated with the prosthesis was of minor importance (4.4%). Histological and scanning--electron microscopical examinations of the bone--metal interface of retrieved human femoral stems were done. The three-dimensional ingrowth of lamellar and woven bone accompanied by dense fibrous tissue into the "spongiosa" metal, cancellous surface of the implant was demonstrated. The clinical consequence of this mechanical "interlocking" up to a depth of 3 mm, supported by the encouraging clinical results, is evident. Cementless spongiosa metal prosthesises should be implanted in patients older than 70 years if the bone stock will be good enough.
我们对截至1986年3月31日所做的138例初次关节成形术进行了临床和影像学回顾。平均随访76个月（60至102个月）。125例（90.6%）髋关节可归类为优/良，8例（5.8%）为中，5例（3.6%）为差。术前Harris髋关节评分平均为43.6（12.61）分，6年时平均评分为91.2（63 - 100）分。植入两年后，与假体相关的大腿疼痛并不严重（4.4%）。对取出的人体股骨柄的骨 - 金属界面进行了组织学和扫描电子显微镜检查。结果显示，板层骨和编织骨伴随着致密纤维组织向“松质骨”金属（植入物的松质骨表面）三维长入。这种机械性“嵌合”深度达3毫米，且临床结果令人鼓舞，其临床意义显而易见。如果骨量足够，对于70岁以上的患者应植入非骨水泥型松质骨金属假体。
