Judas Fernando Monteiro, Rodrigues Joana Bento, Lucas Francisco Manuel, Freitas João Paulo
Department of Orthopaedics, CHUC, Coimbra, Coimbra, Portugal.
BMJ Case Rep. 2014 Jul 2;2014:bcr2014204821. doi: 10.1136/bcr-2014-204821.
We report a case of a 63-year-old man who presented an end stage hip osteoarthritis 42 years after a proximal femoral osteotomy performed for the treatment of an intracapsular femoral neck fracture. A cemented total hip arthroplasty was implanted using a standard posterior approach. The osteotomy hardware was totally covered with a new cortical bone formation. A layer of bone tissue was removed, the screw heads were broken and the nail plate was also removed. The screw threaded portions were retained because they did not interfere with cemented femoral stem implantation. Fourteen years after total hip arthroplasty, the patient reported no pain and expressed high satisfaction with the surgery. The hip radiograph showed wear of the polyethylene cup and no periprosthetic osteolysis. Retention of hardware can be considered, especially in patients who have had hardware for several years, without any negative symptoms.
我们报告一例63岁男性患者，其在因囊内股骨颈骨折接受股骨近端截骨术42年后出现终末期髋关节骨关节炎。采用标准后入路植入骨水泥型全髋关节置换假体。截骨内固定装置完全被新形成的皮质骨覆盖。去除一层骨组织，拧断螺钉头部并取出钉板。保留螺钉螺纹部分，因为它们不影响骨水泥型股骨柄植入。全髋关节置换术后14年，患者无疼痛主诉，对手术表示高度满意。髋关节X线片显示聚乙烯髋臼杯磨损，无假体周围骨溶解。对于已植入内固定装置数年且无任何不良症状的患者，可考虑保留内固定装置。
