Morscher E W, Hefti A, Aebi U
Orthopaedic Department, University of Basel, Switzerland.
J Bone Joint Surg Br. 1998 Mar;80(2):267-72. doi: 10.1302/0301-620x.80b2.8316.
One concern about the fixation of HA-coated implants is the possible disintegration of the surface, with the migration of HA granules into the joint space, producing third-body wear. We report a study of six revisions of HA-coated polyethylene RM cups at 9 to 14 years after successful primary arthroplasty. In all six hips, we found HA granules embedded in the articulating surface of the polyethylene, with abrasive wear of the cup and the metal femoral head. The cup had loosened in four hips and three showed severe osteolysis of the proximal femur. Third-body wear due to HA particles from implant coating may produce severe clinical problems with few early warning signs. Further clinical, radiological and histological observations are needed to determine the possible incidence of this late complication in the various types of coating of a variety of substrates.
对于羟基磷灰石（HA）涂层植入物固定的一个担忧是其表面可能会崩解，HA颗粒迁移到关节间隙，导致三体磨损。我们报告了一项对成功进行初次关节置换术后9至14年的6例HA涂层聚乙烯RM杯翻修病例的研究。在所有6个髋关节中，我们发现HA颗粒嵌入聚乙烯的关节表面，杯体和金属股骨头出现磨蚀性磨损。4个髋关节的杯体发生松动，3个显示股骨近端严重骨溶解。植入物涂层中的HA颗粒导致的三体磨损可能会产生严重的临床问题，且早期预警信号很少。需要进一步进行临床、放射学和组织学观察，以确定这种晚期并发症在各种类型的涂层和各种基体中的可能发生率。
