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Early loosening of hip replacements: causes, course and diagnosis

机译:髋关节置换术的早期松动:原因,病程和诊断

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摘要

Early loosening of joint implants is largely determinated by a combination of five factors (patient, material, implant design, fixation and operative technique). To preserve bone stock, avoid complex reconstructive surgery, obtain good functional results and relief of pain the indication for revision should be made at an early stage on the basis "of the diagnostic trio "history, clinical findings, radiography" and not delayed unnecessarily. Regular clinical examination and control radiographs following discharge from hospital enable surgeons to recognize early signs of complications. A useful algorithm is radiographs in two planes taken after one, two, and five years and in cases without visi-ble morphological changes and pain also after ten years (cumulative risk of failure <5%). If there is an evidence of one or two radiographic criteria for loosening (sintering, migration, radiolucency, osteolysis) the risk that the implant will fail is increased by 5 to 10 times.
机译:关节植入物的早期松动在很大程度上由五个因素(患者,材料,植入物设计,固定和手术技术)共同决定。为了保留骨储备,避免进行复杂的重建手术,获得良好的功能效果并减轻疼痛,应在早期根据“诊断三重病”的病史,临床表现,影像学检查做出适应症,不要不必要地拖延。出院后定期进行临床检查和控制X光片可以使外科医生识别并发症的早期征兆,一种有用的算法是在1年,2年和5年后在两架飞机上进行X光片检查,如果在10天后也没有明显的形态学变化和疼痛,年(失败的累积风险<5%)。如果有一项或两项放射学检查标准表明有松动(烧结,迁移,放射线不透,溶骨),则植入物失败的风险会增加5到10倍。

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