Vol.XXXVII, Suppl. 1 - Giornale Italiano di Ortopedia e Traumatologia
Vol.XXXVII, Suppl. 1 - Giornale Italiano di Ortopedia e Traumatologia
Vol.XXXVII, Suppl. 1 - Giornale Italiano di Ortopedia e Traumatologia
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s86<br />
taB. i. Usura <strong>di</strong> polietileni <strong>di</strong> terza generazione.<br />
anno autore f.u. usura lineare<br />
x anno<br />
2005 Manning 24 m 0,007<br />
Manning 0,02<br />
2004 Wroblewsky 4,3 a 0,03<br />
2005 Krushell 47 m 0,05<br />
2001 Kawamura 12 a 0,05<br />
2005 D’Antonio 5 a 0,05<br />
2010 Pace 8-9 a 0,069<br />
1999 Wrobleswsky 0,08<br />
2005 Kim 7 a 0,08<br />
1999 Clohisy 0,10<br />
2001 Pedersen 0,12<br />
1997 Shaver 0,15<br />
2005 Röhrl 24 m 0,15<br />
2004 Mccombe 6,5 a 0,15<br />
2006 Wan 24 m 0,17<br />
2006 Wan 2-5 a 0,22<br />
Bibliografi a<br />
1 Freeman MA, Plante-Bordeneuve P. Early<br />
migration and late aseptic failure of proximal<br />
femoral prostheses. Bone Joint Surg Br<br />
1994;76:432-8.<br />
2 Walker PS, Mai SF, Cobb AG, et al. Pre<strong>di</strong>ction<br />
of clinical outcome of THR from migration<br />
measurements on standard ra<strong>di</strong>ographs.<br />
A study of cemented Charnley and Stanmore<br />
femoral stems. J Bone Joint Surg Br<br />
1995;77:705-14.<br />
3 Selvik G. Roentgen stereophotogrammetry: a<br />
method for the study of the kinematics of the<br />
skeletal system. Acta Orthop Scand <strong>Suppl</strong><br />
1989;232:1-51.<br />
4 Krismer M, Stöckl B, Fischer M, et al.<br />
Early migration pre<strong>di</strong>cts late aseptic failure<br />
of hip socket. J.Bone Joint Surg Br<br />
1996;78:422-6.<br />
5 Krismer M, Biederman R, Stöckel B, et al.<br />
The pre<strong>di</strong>ction of failure of the stem in<br />
THR by measurement of early migration<br />
using EBRA-FCA. J Bone Joint Surg Br<br />
1999;81:273-80.<br />
6 Eingartner C, Heigele T, Dieter J, et al. Longterm<br />
results with the BiCONTACT system--<br />
V. saLVi<br />
aspects to investigate and to learn from. Int<br />
Orthop. 2003;27(<strong>Suppl</strong> 1):S11-5.<br />
7 Van Goethem C, Pfl uger DH. Assessment of<br />
early migration and clinical evaluation of<br />
a cemented femoral stem. Acta Ortho Belg<br />
2005;71:555-64.<br />
8 Radl R, Hungerford M, Materna W, et al.<br />
Higher failure rate and stem migration of<br />
an uncemented femoral component in patients<br />
with femoral head osteonecrosis than<br />
in patients with osteoarthrosis. Acta Orthop<br />
2005;76:49-55.<br />
9 Klestil T, Biedermann R, Kruger A, et al. Cementless<br />
hemiarthroplasty in femoral neck<br />
fractures: evaluation of clinical results and<br />
measurement of migration by EBRA-FCA. Arch<br />
Orthop Trauma Surg 2006;126:380-6.<br />
10 Ilchmann T, Eingartner C, Heger K, et al.<br />
Femoral subsidence assessment after hip<br />
replacement: an experimental study. Ups J<br />
Med Sci 2006;111:361-9.<br />
11 Ince A, Lermann J, Göbel S, et al. No increased<br />
stem subsidence after arthroplasty in<br />
young patients with femoral head osteonecrosis:<br />
41 patients followed for 1-9 years.<br />
Acta Orthop 2006;77:866-70.<br />
Nella Tabella I sono riportati i dati <strong>di</strong> recenti ricerche sul<br />
dato <strong>di</strong> usura <strong>di</strong> polietileni <strong>di</strong> terza generazione dai quali<br />
emergono valori <strong>di</strong> assai bassa usura rispetto a quelli che<br />
hanno portato alla malattia da detriti. La valutazione <strong>di</strong> un<br />
nuovo tipo <strong>di</strong> materiale denominato PEEK (PACE lavoro in<br />
corso <strong>di</strong> pubblicazione) è stata da me eseguita sia con la<br />
meto<strong>di</strong>ca EBRA che con le misurazioni me<strong>di</strong>ante ROMAN.<br />
concLusioni<br />
La possibilità <strong>di</strong> in<strong>di</strong>viduare precocemente nelle artroprotesi<br />
d’anca sia lo scollamento asettico che la malattia da<br />
detriti per usura del polietilene consentono <strong>di</strong> attuare interventi<br />
riparativi meno invadenti e meno complessi <strong>di</strong> quelli<br />
cui si fa abitualmente ricorso. Le meto<strong>di</strong>che <strong>di</strong>sponibili<br />
esistenti come la RSA sono molto precise ma <strong>di</strong> complessa<br />
e <strong>di</strong>ffi cile attuazione utili soprattutto nello stu<strong>di</strong>o <strong>di</strong> numeri<br />
più limitati <strong>di</strong> nuovi impianti protesici; meto<strong>di</strong>che più facilmente<br />
attuabili come il metodo EBRA o le misurazioni<br />
con il metodo ROMAN consentono <strong>di</strong> in<strong>di</strong>viduare precocemente<br />
i soggetti a rischio e <strong>di</strong> ridurre <strong>di</strong> conseguenza il<br />
gran numero <strong>di</strong> controlli ra<strong>di</strong>ografi ci successivi nei followup<br />
abituali <strong>di</strong> più consistenti casistiche routinarie.<br />
12 Buratti CA, D’Arrigo C, Guido G, et al Assessment<br />
of the initial stability of the Symax<br />
femoral stem with EBRA-FCA: a multicentric<br />
study of 80 cases. Hip Int 2009;19;1:24-9.<br />
13 Digas G, Karrholm J, Thanner J, et al. The<br />
Otto Aufranc Award. Highly cross-linked<br />
polyethylene in total hip arthroplasty: randomized<br />
evaluation of penetration rate in<br />
cemented and uncemented sockets using ra<strong>di</strong>ostereometric<br />
analysis. Clin Orthop Relat<br />
Res 2004;(429):6-16.<br />
14 Rohrl S, Nivbrant B, Mingguo L, et al. In vivo<br />
wear and migration of highly cross-linked<br />
polyethylene cups a ra<strong>di</strong>ostereometry analysis<br />
study. J Arthroplasty 2005;20:409-13.<br />
15 Eggli S, z’Brun S, Gerber C, et al. Comparison<br />
of polyethylene wear with femoral heads of 22<br />
mm and 32 mm. A prospective, randomised<br />
study. J Bone Joint Surg Br 2002;84:447-51.<br />
16 Geer<strong>di</strong>nk CH, Grimm B, Vencken W, et al.<br />
The determination of linear and angular penetration<br />
of the femoral head into the acetabular<br />
componwnt as an assessment of wear in<br />
total hip reaplacement. A comparison of four<br />
computer-assisted methods. J Bone Joint Surg<br />
Br 2008;90:839-46.