University of California at Davis, Sutter General Hospital, Sacramento, California 95816, USA.
J Arthroplasty. 2010 Oct;25(7):1168.e1-4. doi: 10.1016/j.arth.2009.08.015. Epub 2009 Dec 5.
Infection, loosening, osteolysis, or other causes can lead to the development of pain about a previously well-functioning total hip arthroplasty. An inflammatory reaction unique to metal on metal arthroplasty can lead to a painful total hip. A synovial biopsy is needed to make this specific diagnosis, and included in the differential diagnosis is infection. The workup of infection includes obtaining a C-reactive protein and erythrocyte sedimentation rate. Elevations of both the C-reactive protein and erythrocyte sedimentation rate are felt to indicate possible infection. This case report describes both of these findings and the treatment rendered in a painful subluxing metal-on-metal total hip arthroplasty presenting with ongoing pain and a large effusion.
感染、松动、骨溶解或其他原因可导致先前功能良好的全髋关节置换术后出现疼痛。金属对金属关节置换术后特有的炎症反应可导致全髋关节疼痛。需要进行滑膜活检以做出明确诊断，同时需要与感染进行鉴别诊断。感染的检查包括 C 反应蛋白和红细胞沉降率的检测。C 反应蛋白和红细胞沉降率升高提示可能存在感染。本病例报告描述了一例疼痛性半脱位金属对金属全髋关节置换术后出现持续性疼痛和大量关节积液的病例，该患者同时存在这两种情况，并介绍了治疗方法。
