Titanium fibermetal segmental replacement prostheses. A radiographic analysis and review of current status.
Titanium fibermetal segmental replacement prostheses. A radiographic analysis and review of current status.
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DOI：
10.1097/00003086-198603000-00030
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发表时间：
1986-03
影响因子：
4.2
通讯作者：
D. Heck;E. Chao;F. Sim;D. Pritchard;T. Shives
中科院分区：
文献类型：
--
作者：
D. Heck;E. Chao;F. Sim;D. Pritchard;T. Shives
对13例钛纤维节段性骨/关节假体患者进行了至少6个月的随访。对详细的放射学数据进行定量分析，包括假体的茎/骨界面、放射透明度和假体节段上预定区域的骨桥接情况。尽管在本组中，茎干透影线很常见，但只有一例出现临床松动，需要再次手术。有两例骨柄骨折，一例未翻修就获得了皮外骨愈合，另一例需要取出植入物并翻修。对取回的标本的分析揭示了骨长入的组织学证据。使用长侧钢板进行初始内固定可能是导致这种并发症的部分原因，因为它抑制了多孔涂层节段上的新骨形成。在相同的分区分析标准下，对不同随访时间段的X线片的连续研究表明，在骨/假体界面上没有出现放射透明的进展，节段部分的骨形成随着时间的推移而增加或稳定。患者的功能结果和植入性能似乎表明，多孔涂层节段性假体系统在桥接骨/关节缺损方面是有效的。然而，假体设计和假体质量控制还需要进一步改进，以最大限度地减少与装置相关的并发症。
Thirteen patients with titanium fibermetal segmental bone/joint prostheses at a minimum follow-up period of six months were reviewed. Detailed radiographic data were analyzed quantitatively in terms of stem/bone interface radiolucency and bone bridging over the segmental portion of the prosthesis at predefined zones. Although stem radiolucent lines were common in this series, only one case had clinical loosening and required reoperation. There were two cases of stem fracture; one achieved extracortical bone union without revision, and the other case required implant removal and revision. Analysis of the retrieved specimen revealed histologic evidence of bony ingrowth. The use of a long side plate for initial implant fixation might have been partially responsible for this complication because of inhibition of new bone formation over the porous-coated segment. Sequential study of radiograms at different follow-up time periods with the same zonal analysis criteria revealed that no progression of radiolucency occurred at the bone/prosthesis interface, and bone formation over the segmental portion either increased or stabilized with time. The patients' functional results and implant performance seemed to indicate that the porous-coated segmental prosthetic system was effective in bridging skeletal/joint defects. However, further improvements are needed in prosthetic design and implant quality control in order to minimize device-related complications.