Barrack R L, Folgueras A, Munn B, Tvetden D, Sharkey P
Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA 70112, USA.
Clin Orthop Relat Res. 1997 Feb(335):211-7.
The clinical and radiographic results of 160 primary, uncemented porous coated total hip replacements performed at 3 teaching hospitals were reviewed. Followup was obtained in 132 of 148 (89%) nondeceased patients. The acetabular component is a full hemisphere, fabricated of cobalt chrome with a sintered bead coating and was implanted with screws in all cases. A 32 mm cobalt chrome femoral head was used in all cases. At 2 to 4 years the incidence of pelvic lysis was 0 and no acetabular revisions had been performed. At 5 to 8 years followup, 3 of 132 (2%) femoral stems had been revised, while on the acetabulum side discrete expansile pelvic lytic lesions occurred in 15 cases (11%) with 8 cases (5%) requiring revision. Abrasion of the screwhead against the backside of the polyethylene liner was seen in all retrieved cases and may have contributed to the development of the lytic lesions seen. Use of this uncemented press fit hemispheric acetabular components, using adjunctive screw fixation resulted in an unacceptably high rate of polyethylene wear and aggressive pelvic lysis. While the results on the femoral side were good, the results with this uncemented acetabular system did not represent an improvement over previous cemented or uncemented acetabular components.
对3家教学医院进行的160例初次非骨水泥多孔涂层全髋关节置换术的临床和影像学结果进行了回顾。在148例未死亡患者中，有132例（89%）获得了随访。髋臼组件为全半球形，由钴铬合金制成，带有烧结珠涂层，所有病例均用螺钉植入。所有病例均使用32毫米钴铬合金股骨头。在2至4年时，骨盆溶解的发生率为0，且未进行髋臼翻修。在5至8年的随访中，132个股骨柄中有3例（2%）进行了翻修，而在髋臼侧，15例（11%）出现了离散性扩张性骨盆溶解性病变，其中8例（5%）需要翻修。在所有取出的病例中均可见螺钉头与聚乙烯衬垫背面的磨损，这可能促成了所见溶解性病变的发展。使用这种非骨水泥压配半球形髋臼组件并采用辅助螺钉固定，导致聚乙烯磨损率过高且骨盆溶解性病变进展迅速。虽然股骨侧的结果良好，但这种非骨水泥髋臼系统的结果并不比以前的骨水泥或非骨水泥髋臼组件有所改善。
