Rubash H E, Sinha R K, Shanbhag A S, Kim S Y
Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pennsylvania, USA.
Orthop Clin North Am. 1998 Apr;29(2):173-86. doi: 10.1016/s0030-5898(05)70316-3.
Bone loss with or without evidence of aseptic loosening is a long term complication after total hip arthroplasty (THA). It occurs with all materials and in all prosthetic systems in use or that have been used to date. Bone loss after THA can be a serious problem in revision surgery because bone deficiencies may limit reconstructive options, increase the difficulty of surgery, and necessitate autogenous or allogenic bone grafting. There are three factors adversely affecting maintenance of bone mass after THA: (1) bone loss secondary to particulate debris; (2) adaptive bone remodeling and stress shielding secondary to size, material properties, and surface characteristics of contemporary prostheses; and (3) bone loss as a consequence of natural aging. This chapter reviews the mechanisms of the primary causes of bone loss after THA.
无论有无无菌性松动证据，骨量丢失都是全髋关节置换术（THA）后的一种长期并发症。它在所有材料以及目前使用或曾经使用过的所有假体系统中都会出现。THA后的骨量丢失在翻修手术中可能是一个严重问题，因为骨缺损可能会限制重建选择、增加手术难度，并需要自体或异体骨移植。有三个因素对THA后骨量的维持产生不利影响：（1）颗粒碎片导致的骨量丢失；（2）当代假体的尺寸、材料特性和表面特征所导致的适应性骨重塑和应力遮挡；（3）自然衰老导致的骨量丢失。本章回顾了THA后骨量丢失主要原因的机制。
