Lee E W, Kim H T
Orthopaedic Surgery Section, San Francisco VA Medical Center, San Francisco, California.
J Arthroplasty. 2001 Feb;16(2):236-8. doi: 10.1054/arth.2001.20542.
Femoral component fracture is a rare but well-documented complication after total hip arthroplasty. Historically, most stem fractures have occurred at the middle third of the implant, where proximal stem loosening and solid distal stem fixation result in cantilever bending and eventual fatigue failure. In contrast, we report 2 early fatigue failures of well-positioned, well-fixed, cemented, forged, cobalt-chromium femoral components at the neck-shoulder junction. A contributing factor to the implant failures was heavy laser etching in a region of the implant subjected to high stresses, leading to decreased fatigue resistance and subsequent fracture.
股骨部件骨折是全髋关节置换术后一种罕见但有充分文献记载的并发症。从历史上看，大多数柄部骨折发生在植入物的中三分之一处，此处近端柄部松动而远端柄部固定牢固，导致悬臂弯曲并最终出现疲劳失效。相比之下，我们报告了2例定位良好、固定良好、骨水泥固定、锻造的钴铬合金股骨部件在颈肩交界处早期出现疲劳失效的情况。植入物失效的一个促成因素是在植入物承受高应力的区域进行了大量激光蚀刻，导致抗疲劳性降低并随后发生骨折。
