Jennings Jason M, Dennis Douglas A, Yang Charlie C
From Colorado Joint Replacement, Denver, CO (Dr. Jennings, Dr. Dennis, and Dr. Yang), the Department of Biomedical Engineering, University of Denver, Denver (Dr. Dennis), the Department of Orthopaedics, University of Colorado Health School of Medicine, Aurora, CO (Dr. Dennis), and the Department of Biomedical Engineering, University of Tennessee, Knoxville, TN (Dr. Dennis).
J Am Acad Orthop Surg. 2016 Jun;24(6):349-56. doi: 10.5435/JAAOS-D-15-00111.
Corrosion of the head-neck junction of implants used in total hip arthroplasty is a complex problem. Clinical severity appears to be multifactorial, and the predictive variables have yet to be consistently identified in the literature. Corrosion should be considered in the differential diagnosis of hip pain following total hip arthroplasty regardless of the type of bearing surface used. The most common presentation, pain followed by instability, is similar to complications associated with metal-on-metal articulations. The diagnosis of implant corrosion of the head-neck junction can be challenging; an infection workup should be performed along with analysis of serum metal ion levels and cross-sectional imaging. In the short term, a well-fixed stem may be retained, and the exchange of an isolated head with a ceramic femoral head seems to be a promising option for certain implants. Further research with longer follow-up is warranted, and high levels of evidence are needed to determine whether this approach is generalizable.
全髋关节置换术中使用的植入物头颈交界处的腐蚀是一个复杂的问题。临床严重程度似乎是多因素的，且预测变量在文献中尚未得到一致确定。无论使用何种类型的承重表面，在全髋关节置换术后髋部疼痛的鉴别诊断中都应考虑腐蚀问题。最常见的表现是疼痛，随后出现不稳定，这与金属对金属关节相关的并发症相似。诊断植入物头颈交界处的腐蚀可能具有挑战性；应进行感染检查以及血清金属离子水平分析和横断面成像。短期内，固定良好的柄可以保留，对于某些植入物，用陶瓷股骨头替换孤立的股骨头似乎是一个有前景的选择。需要进行更长时间随访的进一步研究，并且需要高水平的证据来确定这种方法是否具有普遍性。
