Strömberg C N, Herberts P, Palmertz B, Garellick G
Department of Orthopedics, Institute of Surgical Sciences, Göteborg University, Sahlgrenska University Hospital, Sweden.
Acta Orthop Scand. 1996 Feb;67(1):43-8. doi: 10.3109/17453679608995607.
The 1-year radiographs in 61 stems and 23 sockets, later revised because of aseptic loosening, were carefully examined for changes such as 1) separation of the lateral side of the stem from the cement, 2) radiolucent zones at the bone-cement interface, 3) fracture of the cement, 4) endosteal cavitation and 5) migration. They were compared with 42 clinically and radiographically successful primary total hip arthroplasties with 12-16 years follow-up. We found an increased risk of loosening in hips where radiolucencies appeared within the first postoperative year, whereas an unchanged radiographic appearance after 1 year strongly indicated that the risk of later loosening was small. Patients at risk should be followed indefinitely to detect progressive loosening and concomitant bone resorption in time.
对61个股骨柄和23个髋臼杯的1年X线片进行了仔细检查，这些假体后来因无菌性松动而进行了翻修，检查内容包括：1）股骨柄外侧与骨水泥分离；2）骨水泥界面的透亮区；3）骨水泥断裂；4）骨内膜空洞形成；5）移位。将这些X线片与42例临床和影像学表现均成功的初次全髋关节置换术的X线片进行比较，后者随访了12至16年。我们发现，术后第一年内出现透亮区的髋关节发生松动的风险增加，而术后1年X线表现无变化则强烈提示后期发生松动的风险较小。对有风险的患者应进行长期随访，以便及时发现进行性松动和伴随的骨质吸收。
