Clarke Henry D, Math Kevin R, Scuderi Giles R
Insall Scott Kelly Institute for Orthopaedics and Sports Medicine, New York, NY 10128, USA.
J Arthroplasty. 2004 Aug;19(5):652-7. doi: 10.1016/j.arth.2004.02.026.
Posterior-stabilized (PS) prostheses have been used extensively in total knee arthroplasty (TKA), with excellent long-term results. The key feature of these prostheses is the femoral cam and tibial post mechanism that limits posterior displacement and produces femoral rollback. Although articular-surface polyethylene wear of the tibial component has not been a significant clinical problem, tibial post wear has been reported. In distinction to chronic post wear, little information exists about catastrophic post failure. We present the case of a 56-year-old woman who presented 63 months after TKA with a PS prosthesis with acute fracture of the polyethylene post. The evaluation and treatment of this patient, including the previously unreported use of computed tomography arthrography to diagnose this rare problem, is reviewed.
后稳定型(PS)假体已广泛应用于全膝关节置换术(TKA),长期效果良好。这些假体的关键特征是股骨凸轮和胫骨柱机制,该机制可限制后移并产生股骨后滚。尽管胫骨部件的关节面聚乙烯磨损尚未成为严重的临床问题,但已有胫骨柱磨损的报道。与慢性柱磨损不同,关于灾难性柱失效的信息很少。我们报告一例56岁女性患者,她在接受TKA并植入PS假体63个月后出现聚乙烯柱急性骨折。本文回顾了该患者的评估和治疗过程,包括此前未报道的使用计算机断层扫描关节造影来诊断这一罕见问题。