Jacobs Joshua J
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois.
J Arthroplasty. 2016 Jul;31(7):1378-80. doi: 10.1016/j.arth.2016.03.029. Epub 2016 Mar 24.
While mechanically-assisted crevice corrosion (MACC) at the head/neck junction of modular total hip arthroplasty (THA) femoral components was first described over two decades ago, it is only within the last few years that investigators have observed that adverse local tissue reactions (ALTRs) associated with MACC are an increasingly prevalent mode of failure of contemporary THAs. As yet, the incidence, etiology and pathogenesis of MACC-associated ALTR are not well understood. In this review, possible implant-, patient-, and surgeon-related factors are considered in the context of a small but growing body of evidence from laboratory simulations, implant and tissue retrieval studies and clinical case series. It is likely that MACC-associated ALTR is a multifactorial process and that ongoing research will lead to multiple strategies that will facilitate early diagnosis and ultimately prevention of the adverse clinical sequelae of this phenomenon.
虽然模块化全髋关节置换术（THA）股骨部件头颈交界处的机械辅助缝隙腐蚀（MACC）早在二十多年前就首次被描述，但直到最近几年，研究人员才观察到与MACC相关的局部组织不良反应（ALTR）是当代THA越来越普遍的失败模式。迄今为止，MACC相关ALTR的发生率、病因和发病机制尚未完全明确。在这篇综述中，我们结合来自实验室模拟、植入物和组织取出研究以及临床病例系列的少量但不断增加的证据，考虑了可能与植入物、患者和外科医生相关的因素。MACC相关ALTR很可能是一个多因素过程，持续的研究将带来多种策略，有助于早期诊断并最终预防这一现象的不良临床后果。
