Huang C H, Yang C Y, Cheng C K
Department of Orthopaedic Surgery, Mackay Memorial Hospital, Taipei, Taiwan, ROC.
J Arthroplasty. 1999 Apr;14(3):375-9. doi: 10.1016/s0883-5403(99)90066-9.
Fracture of the femoral component associated with polyethylene wear and osteolysis after total knee arthroplasty (TKA) has not been well reported before. A 63-year-old man with osteoarthritis of the right knee underwent TKA with a New Jersey LCS Knee, with cementing on the tibia and patella but not on the femoral component. After 42 months, in addition to wearing of polyethylene of the tibia and patella, severe osteonecrosis of the medial femoral condyle was noted. Osteonecrosis caused loss of osseous support of the medial flange of the femoral component, and the bone ingrowth of the central and lateral flange to the distal femur was so good that it overcame the yield stress of the metal of the femoral component and caused fracture of the femoral component. The osteolytic area was filled with autogenous iliac bone, and a new femoral component was inserted and cemented. The patient's condition became satisfactory with relief of pain. Although uncommon, fracture of the femoral component does occur associated with polyethylene wear and osteolysis.
全膝关节置换术（TKA）后股骨假体骨折伴聚乙烯磨损和骨溶解此前尚未见详尽报道。一名63岁的右膝骨关节炎男性接受了使用新泽西LCS膝关节的TKA手术，胫骨和髌骨采用骨水泥固定，但股骨假体未使用骨水泥。42个月后，除了胫骨和髌骨的聚乙烯磨损外，还发现股骨内侧髁严重骨坏死。骨坏死导致股骨假体内侧翼的骨支撑丧失，而中央和外侧翼向股骨远端的骨长入良好，以至于超过了股骨假体金属的屈服应力，导致股骨假体骨折。骨溶解区域用自体髂骨填充，插入并固定了一个新的股骨假体。患者疼痛缓解，病情好转。尽管罕见，但股骨假体骨折确实会与聚乙烯磨损和骨溶解相关联而发生。
