Argelo Kirsten D S, Burger Mick A, Hoozemans Marco J M, Temmerman Olivier P P
CORAL - Centre for Orthopaedic Research Alkmaar, Department of Orthopaedic Surgery, Medical Center Alkmaar, P,O Box 501, 1800 AM Alkmaar, The Netherlands.
J Med Case Rep. 2014 Dec 11;8:419. doi: 10.1186/1752-1947-8-419.
The present case report describes a patient who presented with an early complication after a unicompartmental knee arthroplasty. It is not the first case in this subject but the unique aspect of this case report rests on the timing in which the failure occurred.
A 64-year-old Caucasian man received a medial unicompartmental knee arthroplasty (Oxford® Partial Knee) due to isolated anteromedial osteoarthritis of his right knee. His initial recovery was good, however, after 3 months he presented with acute pain and a locked knee. Radiographs showed a complete loosening and migration of the femoral component. During revision surgery no clear explanation was found for failure of the femoral component.
The most likely explanation for loosening is the combination of peak stresses on the posterior facet of the femoral components of a unicompartmental knee arthroplasty in a patient in a cross-legged knee position causing bone-cement or cement-implant interface failure. Further research is necessary in prosthetic designs and applications of the unicompartmental knee arthroplasty to determine the origin of this early complication.
本病例报告描述了一名患者,其在单髁膝关节置换术后出现了早期并发症。这并非该领域的首例病例,但本病例报告的独特之处在于失败发生的时间。
一名64岁的白人男性因右膝孤立性前内侧骨关节炎接受了内侧单髁膝关节置换术(牛津®部分膝关节置换)。他最初恢复良好,然而,3个月后出现急性疼痛和膝关节交锁。X线片显示股骨部件完全松动并移位。在翻修手术中,未找到股骨部件失败的确切原因。
松动最可能的解释是,盘腿位患者的单髁膝关节置换术股骨部件后关节面的峰值应力导致骨水泥或骨水泥-植入物界面失败。有必要对单髁膝关节置换术的假体设计和应用进行进一步研究,以确定这种早期并发症的根源。