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Radiographic and clinical analysis of cementless acetabular fixation in total hip arthroplasty

Chinese Journal of Traumatology 2005年第5期8卷 263-268页

作者：张晖裴福兴杨静沈彬石锐 Department of Orthopedics West China HospitalSichuan UniversityChengdu610041China

Objective： To investigate the factors affecting the fixation, loosening and therapeutic effect of cementless acetabular prosthesis through following up the patients with total hip arthroplasty clinically and radiographically. Methods： From February 1998 to May 1999, 139 patients （148 hips） underwent total hip arthroplasty with cementless acetabular prosthesis in our department. In this study, the clinical therapeutic effect and the anteroposterior radiographs of the pelvis and anteroposterior and lateral radiographs of the hips of 109 patients （116 hips） made before operation, at 1 week operation and annually 3, 6, and 12 months after thereafter were analyzed retrospectively. The clinical therapeutic effects were evaluated with Harris hip score. Radiographs were used to observe the position of prostheses and the bone changes around the implant, and to measure the wearing speed and direction of the acetabular cup. All evaluations were made by an independent examiner who did not participate in the operation. The patients were followed up for 5-6 years. Results- The mean Harris score was 44 points （ range, 10-70 points ） before operation, but it increased to 92.4 points （ range, 80-100 points） at the latest review after operation, which was significantly higher than that before operation （P 〈 0.05 ）. No acetabular component was revised because of infection or aseptic loosening. And no acetabular component migrated. There was no revision of fixed acetabular component because of pelvic osteolysis secondary to polyethylene wear. The mean linear wear rate was 0.15 mm per year. All the acetabular prostheses were classified as stable on the radiographs. Conclusions ： In terms of fixation, total hip arthroplasty with cementlcss acetabular components was successful. Although there is no aseptic loosening and a low incidence of osteolysis at the latest follow-up evaluation, polyethylene wear cannot be avoided and can lead to expansile osteolysis near the cups. This kind of o

关键词： Arthroplasty, replacement, hip Acetabulum prosthesis failure X-ray film

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Hip prosthetic loosening:A very personal review

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World Journal of Orthopedics 2021年第9期12卷 629-639页

作者： Bengt Mjöberg Department of Orthopedics Lund UniversityLund SE-22100Sweden

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.

关键词： Hip prosthesis prosthesis failure Radiostereometric analysis Bone resorption Bone cements Radionuclide imaging

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Outcome and revision rate of uncemented humeral head resurfacing:Mid-term follow-up study

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World Journal of Orthopedics 2021年第6期12卷 403-411页

作者： Claudio Chillemi Carlo Paglialunga Greta De Giorgi Riccardo Proietti Stefano Carli Marco Damo Department of Orthopaedics and Traumatology Istituto Chirurgico Ortopedico TraumatologicoLatina 04100LazioItaly Department of Anatomical HistologicalForensic Medicine and Orthopaedics SciencesSapienza University of RomeICOTLatina 04100LazioItaly

BACKGROUND Glenohumeral osteoarthritis(OA)is a common cause of pain and disability affecting nearly a third of the world’s population over 60 years of *** in other joints,shoulder arthroplasty appears to be the most effective *** implant design has evolved during time transitioning to shorter humeral stem lengths or even stemless *** To evaluate the medium-term outcome and survival of a cementless humeral head resurfacing(HHR)in a group of patients affected with OA or avascular *** This is a retrospective study of prospectively collected data using HHR in 23 patients(15 female and 8 male)after a 7.4 year *** collected data included clinical and radiographical *** Constant score,the visual analogue scale,and a clinical evaluation of range of motion were registered preand *** patients affected with OA(2 cases of mild,6 moderate,and 7 severe)and 10 with avascular necrosis(stage III according to Cruess classification)were enrolled.X-rays were evaluated to detect loosening signs,degenerative changes,and superior humeral head *** resonance preoperatively was also performed to assess the rotator cuff *** integrity was mandatory to implant the *** In total,19 patients(21 shoulders)completed the *** on 4 shoulders,in 4 patients,were lost because of prosthesis *** global revision rate was 16%.A statistically significant improvement in the mean Constant score,visual analogue scale,and range of motion have been *** signs of loosening were registered,while in 12 cases a glenoid erosion was *** osteophytes appeared 7 times on the humeral side and 12 on the *** humeral migration was recorded in only 1 *** HHR remains a reasonable option in patients with an intact rotator cuff for the treatment of OA and avascular necrosis.

关键词： Shoulder Arthroplasty Humeral head Resurfacing Glenoid erosion prosthesis failure

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Hip prosthetic loosening and periprosthetic osteolysis:A commentary

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World Journal of Orthopedics 2022年第6期13卷 574-577页

作者： Bengt Mjöberg Department of Orthopedics Lund UniversityLund SE-22100Sweden

Prosthetic loosening and periprosthetic osteolysis have been debated for decades,both in terms of the timing and nature of the triggering *** hypothesis of wear-particle-induced loosening states that wear particles cause a foreign-body response leading to periprosthetic osteolysis and ultimately to late prosthetic loosening,i.e.,that the osteolysis precedes the *** theory of early loosening,on the other hand,postulates that the loosening is already initiated during or shortly after surgery,i.e.,that the osteolysis is secondary to the *** commentary focuses on the causal relationship between prosthetic loosening and periprosthetic osteolysis.

关键词： Hip prosthesis Radiostereometric analysis prosthesis failure Osteoclasts Bone resorption Alarmins

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