Falez F, Casella F, La Cava F, Favetti F
Department of Orthopaedics and Trauma, S. Spirito in Sassia Hospital, Rome, Italy.
Hip Int. 2007 Jul-Sep;17(3):179-82. doi: 10.1177/112070000701700311.
The renewed popularity of resurfacing hip arthroplasty (RHA) in the last five years has generated a remarkable quantity of scientific contributions based on mid- and short-term follow-up. In spite of some large series with extremely low complication rates, more than one paper has reported a consistent early revision rate as a consequence of biological or biomechanical failure. Two major complications are commonly described with resurfacing implants: avascular necrosis and neck fracture. A close relationship between these two events has been suggested, but not firmly demonstrated, while surgical exposure and implant positioning seem to be better understood as potential causes of failure. However, it may happen that neither avascular necrosis nor neck fracture can be clearly recognised in a failed resurfacing implant: it is what we have directly experienced, with a missed fracture at the head-neck junction, evolved in non-union, beneath the dome of the femoral component. The present report, besides a brief clinical history, tries to give a possible interpretation of such an unusual complication.
在过去五年中，髋关节表面置换术（RHA）再度流行，基于中期和短期随访产生了大量科学贡献。尽管有一些大宗病例系列报道并发症发生率极低，但不止一篇论文报道了因生物学或生物力学失败导致的一致的早期翻修率。表面置换植入物通常会出现两种主要并发症：缺血性坏死和颈部骨折。这两种情况之间的密切关系已被提出，但尚未得到确凿证实，而手术暴露和植入物定位似乎被更好地理解为潜在的失败原因。然而，在失败的表面置换植入物中，可能既无法明确识别缺血性坏死，也无法明确识别颈部骨折：这是我们直接经历的情况，头颈部交界处出现骨折漏诊，发展为不愈合，位于股骨部件穹顶下方。本报告除了简要的临床病史外，还试图对这种不寻常的并发症给出一种可能的解释。
