Hannouche Didier, Nich Christophe, Bizot Pascal, Meunier Alain, Nizard Rémi, Sedel Laurent
Hôpital Lariboisiére, Paris, France.
Clin Orthop Relat Res. 2003 Dec(417):19-26. doi: 10.1097/01.blo.0000096806.78689.50.
During a period of 25 years (1977 to 2001), 13 fractures of an alumina component were recorded retrospectively. During the same period, approximately 5500 alumina components were implanted (3300 with all-alumina bearings and 1200 with alumina-on-polyethylene). These events occurred in seven women and six men, with a mean age of 59 years and a mean weight of 71 kg. There were eight fractures of the femoral head and five fractures of the socket component. Three fractures clearly were related to trauma (two fractures of the socket and one fracture of the head) and two were related to an abnormal design (one 22-mm head and one extra-long neck). Five fractures occurred without any rational explanation, but two fractures that occurred in the early phase could have been caused by a weaker alumina material. Finally three recent fractures of the liner were related to a change in the design of the material. This has been corrected and no additional fractures were observed. Although this dramatic event is of concern, it is infrequent and easy to solve by a limited revision procedure if done emergently. This rare complication should be balanced with the other complications of THR, including mechanical failures and osteolysis, often described with metal-on-polyethylene prostheses.
在25年期间（1977年至2001年），对13例氧化铝部件骨折进行了回顾性记录。在同一时期，大约植入了5500个氧化铝部件（3300个采用全氧化铝轴承，1200个采用氧化铝对聚乙烯）。这些事件发生在7名女性和6名男性身上，平均年龄59岁，平均体重71千克。其中有8例股骨头骨折和5例髋臼部件骨折。3例骨折明显与外伤有关（2例髋臼骨折和1例股骨头骨折），2例与设计异常有关（1个22毫米的股骨头和1个超长颈）。5例骨折发生时没有任何合理的解释，但早期发生的2例骨折可能是由于氧化铝材料较弱所致。最后，最近有3例衬垫骨折与材料设计的改变有关。这一问题已得到纠正，未观察到其他骨折情况。尽管这一严重事件令人担忧，但它并不常见，如果能紧急进行有限的翻修手术，很容易解决。这种罕见的并发症应与全髋关节置换术的其他并发症相权衡，包括机械故障和骨溶解，这些并发症在金属对聚乙烯假体中经常出现。
