頁籤選單縮合
題 名 | Aseptic Loosening in Hip Arthroplasty with or without Osteolysis |
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作 者 | 蔡清霖; 陳世煌; 劉堂桂; | 書刊名 | 中華民國骨科醫學會雜誌 |
卷 期 | 14:2 1997.06[民86.06] |
頁 次 | 頁108-114 |
專 輯 | 髖關節病變專輯 |
分類號 | 416.61 |
關鍵詞 | Total hip arthroplasty failure; Aseptic loosening; Osteolysis; Mechanical and biological factors; |
語 文 | 英文(English) |
英文摘要 | Aseptic loosening is a clinically important and relatively common problem after total hip arthroplasty (THR). Aseptic loosening defined here as mechanical loosening without obvious osteolysis is different from osteolysis in three facets - etiologically, radiographically and histopathologically; asetpic loosening, characterized by a linear bone resorption pattern and a well organized connective tissue, is distinctly different from osteolysis, characterized by lack of activated fibroblasts and local aggressive bone lysis as a response to particulate wear debris. The particles induce a foreign-body reaction with macrophage accumulation, release of cytokines and metalloproteinases and bone resorption. There are two major elements of THR failure - mechanical and biological. Mechanical factors initiate the loosening process in cemented femoral component. However, the biological factor relates to the initial event or what plays the major role in the cemented acetabular or cementless femoral and acetabular loosening. And two major problems exist in cementless prostheses: One is initial fixation, which belongs to technical failure, and should be avoided; the other is late loosening (osteolysis), particularly polyethelene wear, which still cannot be prevented. To improve the long-term results of total hip arthroplasty, we should improve implantation technique and use appropriate size of cup or stem with metaphyseal fit, minimize wear debris by technological improvements of implant materials or designs and by modulating this adverse reaction pharmacologically through further understanding of loosening processes. |
本系統中英文摘要資訊取自各篇刊載內容。