Cooke T D, Collins A, Wevers H W
Department of Surgery, Queen's University, Kingston, Ontario, Canada.
Clin Orthop Relat Res. 1990 Sep(258):204-8.
A 61-year-old man who received a porous-metal-coated knee implant returned eight months later with chronic synovitis, instability, and loosening of his artificial joint. Subsequently, metal beads were detected in the joint space and soft tissues and were also embedded in the articulating surface of the tibial component. There was scoring of the tibial surface, and polyethylene wear particles were noted in the synovial and fibroconnective-tissue membranes, which had formed beneath the tibial component. Many particles were seen inside giant cells and macrophages. Failure in this case was probably accelerated by the granulomatous response in the soft tissue to wear particles. There was osteolysis rather than new bone growth at the interface with the tibial component. Analysis indicated that poor bead-bonding strength may have initiated the problem. Careful appraisal of the outcome from use of beaded porous-metal-coated devices and assurance of their adequate bonding strength are essential for further progress.
一名61岁男性接受了多孔金属涂层膝关节植入物，八个月后因慢性滑膜炎、关节不稳定和人工关节松动而复诊。随后，在关节间隙和软组织中检测到金属珠，并且这些金属珠还嵌入了胫骨部件的关节表面。胫骨表面有划痕，在胫骨部件下方形成的滑膜和纤维结缔组织膜中发现了聚乙烯磨损颗粒。在巨细胞和巨噬细胞内可见许多颗粒。该病例的失败可能是由于软组织对磨损颗粒的肉芽肿反应加速所致。在与胫骨部件的界面处出现的是骨质溶解而非新骨生长。分析表明，珠子结合强度不佳可能引发了该问题。仔细评估带珠多孔金属涂层装置的使用效果并确保其具有足够的结合强度对于进一步发展至关重要。
