Quack G, Willmann G, Krahl H, Grundei H
Klinik für Orthopädie und Orthopädische Chirurgie mit Sportmedizin, Alfried Krupp von Bohlen und Halbach Krankenhaus, Lübeck.
Biomed Tech (Berl). 1996 Sep;41(9):253-9.
Since 1987, cementless THR acetabular components with coarsely reticulate surfaces (S&G, ESKA) have been implanted in the Department of Orthopaedic Surgery of the Alfried Krupp Hospital in Essen. By 31st December 1995, 590 of these components had been implanted. Follow-up of the first 51 of these completely cement free THRs revealed loosening in an only single case (2%). Despite these good medium-term results, however, it must be expected that over a ten-year period, the life of the THR will decrease, the probable reason being increasing debris caused by polyethylene (PE) wear leading to aseptic loosening. An alternative to the PE/ceramic system of opposing materials would be ceramic/ceramic. Experience to date has shown that the biological inertness of ceramic does not allow ingrowth and bony integration to take place. Against this background an acetabular component employing a metal backing with the 3-dimensional reticulate surface mentioned above and a Biolox ceramic cup insert articulating with a Biolox ceramic femoral head was designed. The result is a cement free modular THR with optimal bony integration properties and articulating surfaces. To investigate the superiority of this new concept, a comparative study involving two groups of 50 patients each, one group receiving the PE/ceramic system, the other the new ceramic/ceramic system, has been initiated.
自1987年以来，具有粗糙网状表面的非骨水泥型全髋关节置换术（THR）髋臼组件（S&G、ESKA）已被植入埃森阿尔弗雷德·克虏伯医院的骨外科。截至1995年12月31日，已植入了590个此类组件。对其中首批51例完全无骨水泥的全髋关节置换术进行随访发现，仅1例（2%）出现松动。然而，尽管中期结果良好，但预计在十年期间，全髋关节置换术的使用寿命会缩短，可能的原因是聚乙烯（PE）磨损导致碎片增加，进而引起无菌性松动。对抗材料的PE/陶瓷系统的一种替代方案是陶瓷/陶瓷。迄今为止的经验表明，陶瓷的生物惰性不允许骨长入和骨整合发生。在此背景下，设计了一种髋臼组件，其采用带有上述三维网状表面的金属背衬以及与Biolox陶瓷股骨头相铰接的Biolox陶瓷杯状植入物。结果是一种具有最佳骨整合特性和关节表面的无骨水泥模块化全髋关节置换术。为了研究这一新概念的优越性，已启动一项比较研究，涉及两组各50例患者，一组接受PE/陶瓷系统，另一组接受新的陶瓷/陶瓷系统。
