Mulliken B D, Bourne R B, Rorabeck C H, Nayak N
University of Western Ontario, London, Canada.
Iowa Orthop J. 1996;16:20-34.
We reviewed the results of 172 plasma-sprayed, titanium primary total hip arthroplasties inserted without cement and followed 5 to 7 years. Hips were replaced for a wide range of diagnoses and patient ages. No femoral components had been revised nor were any considered unstable. Clinical results have been excellent; 88% of hips had either no or slight amount of pain and only 5% of patients had thigh pain when specifically asked. Radiographically, this femoral component achieved stability after an initial subsidence in 9% of cases. Extensive femoral bone resorption was rare, and distal cortical hypertrophy was commonly seen. Pelvic osteolysis occurred in 16 (9%) cases and was considered major in 10 of these. It was the cause of failure of 3 acetabular components. Femoral endosteal lysis was not observed. We concluded that mechanical stability of the Mallory-Head titanium total hip prostheses is excellent. However, significant pelvic osteolysis had occurred commonly with this implant design, and will continue to pose major reconstructive problems in the future.
我们回顾了172例无骨水泥植入的等离子喷涂钛金属初次全髋关节置换术的结果，这些病例随访了5至7年。置换髋关节的诊断范围广泛，患者年龄各异。没有股骨部件进行翻修，也没有任何部件被认为不稳定。临床结果非常好；88%的髋关节没有疼痛或仅有轻微疼痛，只有5%的患者在被特别询问时出现大腿疼痛。在影像学上，9%的病例中股骨部件在最初下沉后实现了稳定。广泛的股骨骨吸收很少见，常见远端皮质肥大。骨盆骨溶解发生在16例（9%）病例中，其中10例被认为是严重的。它是3个髋臼部件失败的原因。未观察到股骨髓腔内骨溶解。我们得出结论，马洛里-黑德钛全髋关节假体的机械稳定性极佳。然而，这种植入物设计常发生显著的骨盆骨溶解，未来仍将构成重大的重建问题。
