van Raay J J, Rozing P M, Eulderink F
Department of Orthopedics, University Hospital, Leiden, The Netherlands.
Acta Orthop Scand. 1993 Jun;64(3):268-72. doi: 10.3109/17453679308993622.
Femoral head remnants, joint capsules and acetabular membranes were retrieved at revision of 40 failed uncemented, Gerard double-cup hip arthroplasties. All femoral heads were covered with a fibrous membrane containing polyethylene and metal particles, macrophages, and giant cells. The same histopathologic features were found in the joint capsules and acetabular membranes. There was a relationship between the amount of polyethylene particles in the fibrous membrane of the femoral head and the presence of osteonecrosis. Resorption of necrotic bone contributed to failure of the arthroplasty, aided by granulomatous reactions to the wear particles that appeared to induce osteolysis. The overall findings indicate that the severity of the foreign body reaction in periprosthetic tissues is related to the amount of wear particles. Future designs of resurfacing hip arthroplasties should be focused on wear-resistant material combinations.
在对40例失败的非骨水泥型杰拉德双杯髋关节置换术进行翻修时，取出了股骨头残余物、关节囊和髋臼膜。所有股骨头均覆盖有一层纤维膜，其中含有聚乙烯和金属颗粒、巨噬细胞和巨细胞。在关节囊和髋臼膜中也发现了相同的组织病理学特征。股骨头纤维膜中聚乙烯颗粒的数量与骨坏死的存在之间存在关联。坏死骨的吸收导致了关节置换术的失败，对磨损颗粒的肉芽肿反应似乎诱导了骨溶解，从而加剧了这种失败。总体研究结果表明，假体周围组织中异物反应的严重程度与磨损颗粒的数量有关。髋关节表面置换术未来的设计应聚焦于耐磨材料组合。
