Campbell Pat, Shimmin Andrew, Walter Len, Solomon Michael
JVL Orthopaedic Research Center, Orthopaedic Hospital, UCLA Department of Orthopaedics, Los Angeles, California 90007, USA.
J Arthroplasty. 2008 Oct;23(7):1080-5. doi: 10.1016/j.arth.2007.09.024. Epub 2008 Mar 14.
We describe 4 patients pooled from our patient populations who presented with groin pain at different periods postoperatively after implantation of a metal-on-metal hip resurfacing. Each patient underwent exploratory surgery after radiographic imaging, hematologic testing, and microbiological assessment of joint aspirations failed to explain their symptoms. Samples of periprosthetic tissues revealed extensive amounts of lymphocytic infiltrates that were suggestive of an immunologic reaction. The patients obtained complete resolution of symptoms subsequent to revision surgery. The incidence of implant failures resulting from metal sensitivity is unknown owing to the difficulty in making a confirmed diagnosis. The possibility that this is the source of groin pain should be considered when other reasons for symptoms of pain and/or joint effusion in hips with metal-on-metal resurfacing arthroplasties have been discounted.
我们描述了从我们的患者群体中挑选出的4例患者，他们在金属对金属髋关节表面置换术后不同时期出现腹股沟疼痛。在影像学检查、血液学检测以及关节穿刺液的微生物学评估均无法解释其症状后，每位患者均接受了探查手术。假体周围组织样本显示大量淋巴细胞浸润，提示存在免疫反应。这些患者在翻修手术后症状完全缓解。由于难以做出确诊，金属敏感性导致植入物失败的发生率尚不清楚。当金属对金属表面置换关节成形术患者出现疼痛和/或关节积液症状的其他原因被排除后，应考虑这可能是腹股沟疼痛的根源。
