【摘要】 目的　探讨人工髋关节置换术后常见并发症的X线表现 ,以期提高对人工髋关节置换术后并发症的早期诊断及病因鉴别诊断能力。方法　回顾性分析 4 6例人工髋关节置换术后由于出现并发症而行翻修术的病例 ,观察其X线表现 ,并通过与手术对照以评价X线对并发症的诊断价值。结果　术后诊断股骨柄无菌松动 34例 ,髋臼假体无菌松动 13例 ,X线表现为假体周围≥ 2mm的轮廓与假体形态一致的透亮带伴或不伴假体移位 ;感染伴股骨柄和 (或 )髋臼假体松动 4例 ,X线表现为假体周围≥ 3mm的轮廓与假体形态不一致的透亮带和 (或 )假体移位 ,同时伴有骨质破坏、窦道形成等 ;股骨头脱位 6例 ,X线 2例表现为股骨头位于髋臼外 ,2例表现为股骨头中心型移位 ,2例表现为股骨头在髋臼假体内不对称。结论　透亮带和假体移位是松动最重要的X线表现 ,透亮带的形态和窦道的形成有助于鉴别感染性和无菌性松动。髋臼内股骨头位置的不对称或股骨头完全位于髋臼外为股骨头半脱位或脱位的表现更多还原

【Abstract】 Objective To explore the X ray imaging of the common complications after total hip replacement (THR), in order to improve the diagnosis and differential diagnosis of the complications of THR. Methods Forty six cases were revised because of the complications of THR. The value of X ray in the diagnosis of complications was assessed by observing the radiography and comparing with surgical results. Results In these cases, after revision, 34 cases had aseptic loosening of femoral component, 13 cases had aseptic loosening of acetabular component, presenting on radiographs as the lucent zone alone the component, which was ≥2 mm in width and had the same contour as the component. 4 cases had septic loosening of femoral and (or) acetabular component, presenting on radiographs as the lucent zone alone the component, and bone destruction and sinus were also observed. The lucent zone was also ≥3 mm, but had the different contour of the component. Both kinds of loosening may accompany with migration of the component or not. 6 cases had dislocation of femoral head, presenting on radiographs as the head lying out of acetabulum in 2 cases, central migrating of the head in 2 cases, and asymmetrical position of the head in acetabulum in 2 cases. Conclusion The lucent zone and component migration had the important diagnostic value of loosening, the contour of lucent zone and sinus could help to make the differential diagnosis of aseptic and septic loosening. Asymmetrical position of the head in acetabulum and the head lying out of acetabulum were the signs of dislocation.更多还原