陶瓷内衬在金属髋臼中完全植入的研究

A study on complete seating of acetabular insert in Trident ceramic system

目的 探讨陶瓷内衬在髋臼非完全性植入的发生率及分析其发生的因素.方法 本研究对所有在两家本地医院使用Trident陶瓷内衬关节的患者进行回顾性研究.从2003年7月到2007年3月, 共35例患者,平均年龄是50.2岁（29～65岁）.平均随访时间18.2个月（2～46个月）.用X线片评估髋臼内衬植入的完全性.结果 本组有7例患者（20%）髋臼内衬的植入不完全,臼杯和内衬之间留有间隙.4例间隙的位置在外上方,另3例在内下方.所有患者在最后随访时,间隙都没有消失.结论 Trident髋臼的设计特点,令内衬在完全植入之前,容易被臼杯卡住.因为X线投照中心的不同,使这个错误的发生率和严重性被低估.

Objective To assess the incidence of incomplete seating of ceramic liner in the Trident acetabular system. Methods This is a retrospective study of all cases using the Trident cup with ceramic liner in two local hospitals. There were 35 cases from July 2003 to March 2007. The average age of patients was 50. 2 years （range 29 -65）. The average follow- up time was 18. 2 months （range 2 -46）. X-rays were used to assess the completeness of liner seating. Results There were 20% （7 cases） cases of which the ceramic liner seating was incomplete. The gaps were on the superiolateral side in four cases, and on the inferiomedial side in the other three. No re-seating was observed in all mis-seated cases at the latest follow- up. Conclusions The features of Trident cup make the insert seating prone to get stuck before complete seating. X-ray examination tends to underestimate the incidence and severity of this error because of the viewing angle. Long term follow- up is needed to study its effect on metallosis, aseptic loosening, fatigue fracture of the components and survivorship.