Aspenberg P, Van der Vis H
Department of Orthopedics, Lund University Hospital, Sweden.
Clin Orthop Relat Res. 1998 Jul(352):75-80.
Distal migration of the femoral component of a total hip replacement by as little as 0.33 mm during the first 6 postoperative months is predictive of the need for revision many years later. Because the fate of the prostheses is defined so early, it is unlikely that wear particles initiate loosening. However, the progression from the stage of early migration to clinical loosening has unknown causes, of which particles may be one. Slight instability associated with migration will lead to locally high fluid pressures surrounding the migrating prosthesis. Recent experiments applied a moderate fluid pressure to an implant to bone interface. This induced osteocyte death near the implant and subsequent bone resorption. Thus, there is evidence that fluid pressure and ensuing flow could be a main cause of not only pain, but also osteolysis necessitating revision.
全髋关节置换术中股骨部件在术后最初6个月内仅0.33毫米的远端移位就预示着多年后需要进行翻修。由于假体的命运在这么早的时候就已确定，磨损颗粒引发松动的可能性不大。然而，从早期移位阶段发展到临床松动的原因尚不清楚，颗粒可能是其中之一。与移位相关的轻微不稳定性会导致移位假体周围局部产生高流体压力。最近的实验对植入物与骨界面施加了适度的流体压力。这导致植入物附近的骨细胞死亡以及随后的骨吸收。因此，有证据表明流体压力及随之产生的流动不仅可能是疼痛的主要原因，也是导致需要翻修的骨溶解的主要原因。
