Nourbash P S, Paprosky W G
Department of Orthopaedic Surgery, Central DuPage Hospital, Chicago, IL, USA.
Clin Orthop Relat Res. 1998 Oct(355):189-99.
In the early 1980s increased interest in proximally porous coated stems was sparked by first generation cemented stem failures in young patients and concerns with extensively porous coated cementless stems regarding thigh pain and stress shielding. As a result, various proximally porous coated stems were produced, each with differing clinical results. Using 5-year minimal followup as a cut off, the evolution of proximally porous coated stems during the years is presented and compared with the long term results obtained with extensively porous coated stems. Problems with some of the early proximally coated designs have been reported in the literature. Despite subsequent design modifications, the modern proximally coated stem has not eliminated thigh pain or stress shielding. Although some of the proximally porous coated stems have had good results, the question whether the push for proximally coated femoral stems resulted in significant clinical improvement versus the long term results of extensively porous coated stems remains.
20世纪80年代初，年轻患者中第一代骨水泥柄出现故障，以及人们对广泛多孔涂层非骨水泥柄的大腿疼痛和应力遮挡问题的担忧，引发了对近端多孔涂层柄的更多关注。结果，生产出了各种近端多孔涂层柄，每种的临床结果都不同。以5年的最短随访为截止点，介绍了这些年来近端多孔涂层柄的发展情况，并与广泛多孔涂层柄的长期结果进行了比较。文献中报道了一些早期近端涂层设计存在的问题。尽管随后进行了设计改进，但现代近端涂层柄仍未消除大腿疼痛或应力遮挡。虽然一些近端多孔涂层柄取得了良好的效果，但与广泛多孔涂层柄的长期结果相比，推动近端涂层股骨干柄是否带来了显著的临床改善这一问题仍然存在。
