Hip prosthetic loosening:A very personal review

作     者：Bengt Mjöberg 

作者机构：Department of OrthopedicsLund UniversityLund SE-22100Sweden 

出 版 物：《World Journal of Orthopedics》 (世界骨科杂志（英文版）)

年 卷 期：2021年第12卷第9期

页      面：629-639页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Hip prosthesis Prosthesis failure Radiostereometric analysis Bone resorption Bone cements Radionuclide imaging 

摘      要：Hip prosthetic loosening is often difficult to detect at an early stage,and there has been uncertainty for a long time as to when the loosening occurs and thus to the basic *** comparing different diagnostic methods,we found that loosening is best defined as prosthetic migration and measured by radiostereometric *** evidence indicates that poor interlock,poor bone quality,and resorption of a necrotic bone bed may initiate loosening during or shortly after surgery;this forms the basis of the theory of early *** factors do affect the subsequent progression of loosening,which may increase subclinically during a long period of ***,the loosening may be detected on standard radiographs and may be interpreted as late loosening but should to be interpreted as late detection of *** theory of early loosening explains the rapid early migration,the development of periprosthetic osteolysis and granulomas,the causality between wear and loosening,and largely the epidemiology of clinical failure of hip *** discussed are definition of loosening,the pattern of early migration,the choice of migration threshold,the current understanding of loosening,a less exothermic bone cement,cemented taper-slip stems,a new exciting computed tomography-based technique for simpler implant migration studies,and research suggestions.