假瘤治疗中的轴承置换
Bearing exchange in the management of pseudotumours.
作者信息
Kemp M A, Mitra A, da Costa T Mendes, Spencer R F
机构信息
Weston Area Health NHS Trust, UK.
出版信息
Ann R Coll Surg Engl. 2013 May;95(4):266-70. doi: 10.1308/003588413X13511609958497.
INTRODUCTION
Soft tissue reactions following metal-on-metal (MoM) arthroplasty of the hip have been under considerable discussion. These reactions are seen following both hip resurfacing and MoM total hip arthroplasty (THA). The phenomenon may arise owing to shedding of metal particles in high wear states, hypersensitivity with normal metal wear rates or a combination of the two.
METHODS
Three patients were identified who had developed a soft tissue reaction (pseudotumour) following MoM hip resurfacing procedures. The prostheses were revised to ceramic-on-ceramic (CoC) THA with only minimal debridement of the pseudotumour. Pre and postoperative magnetic resonance imaging was performed to assess the size of the lesions.
RESULTS
Progressive and satisfactory resolution of the associated pseudotumours was identified following revision of the prostheses to CoC THA.
CONCLUSIONS
In the early stages of pseudotumour formation following MoM hip resurfacing, this potentially devastating condition can be managed adequately with revision to a CoC bearing THA with minimal soft tissue excision.
引言
金属对金属（MoM）髋关节置换术后的软组织反应一直备受争议。髋关节表面置换术和MoM全髋关节置换术（THA）后均可见到这些反应。这种现象可能是由于高磨损状态下金属颗粒的脱落、正常金属磨损率下的超敏反应或两者的结合所致。
方法
确定了3例在MoM髋关节表面置换术后出现软组织反应（假肿瘤）的患者。假体被翻修为陶瓷对陶瓷（CoC）THA，仅对假肿瘤进行了最小程度的清创。术前和术后进行磁共振成像以评估病变大小。
结果
将假体翻修为CoC THA后，相关假肿瘤逐渐得到满意的消退。
结论
在MoM髋关节表面置换术后假肿瘤形成的早期阶段，通过翻修为CoC承重THA并最小程度地切除软组织，这种潜在的破坏性疾病可以得到充分的治疗。
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