Santavirta S, Hoikka V, Eskola A, Konttinen Y T, Paavilainen T, Tallroth K
Orthopaedic Hospital, Invalid Foundation, Helsinki, Finland.
J Bone Joint Surg Br. 1990 Nov;72(6):980-4. doi: 10.1302/0301-620X.72B6.2246301.
We describe six patients with aggressive granulomatous lesions around cementless total hip prostheses. Two patients previously had a cemented prosthesis in the same hip. The Lord prosthesis was used in five patients, the PCA in one. Both prostheses were made of chrome-cobalt alloy. Pain on weight-bearing occurred on average 3.2 years after the cementless arthroplasty, and at that time radiography revealed aggressive granulomatosis around the proximal femoral stem and the acetabular component in five of the patients; one had a large solitary granuloma in the proximal femur. Revision was performed on average 4.8 years after the cementless arthroplasty. At that time all granulomas had grown large in size; while waiting for revision operation, two femoral stem components fractured. All the granulomas showed a uniform histopathology, which included histiocytosis; the cause for these lesions was thought to be plastic debris from the acetabular socket.
我们描述了6例非骨水泥型全髋关节置换术后出现侵袭性肉芽肿病变的患者。其中2例患者之前在同一髋关节植入过骨水泥型假体。5例患者使用的是洛德假体，1例使用的是PCA假体。两种假体均由铬钴合金制成。非骨水泥型关节置换术后平均3.2年出现负重疼痛，此时X线检查显示5例患者股骨近端柄和髋臼部件周围存在侵袭性肉芽肿；1例患者在股骨近端有一个巨大的孤立性肉芽肿。非骨水泥型关节置换术后平均4.8年进行了翻修手术。此时所有肉芽肿均已长大；在等待翻修手术期间，2个股骨柄部件发生骨折。所有肉芽肿均表现出一致的组织病理学特征，包括组织细胞增多症；这些病变的原因被认为是髋臼窝的塑料碎片。
