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一名肢端肥大症患者全髋关节置换术后的无菌性松动:病例报告

Aseptic Loosening after Total Hip Arthroplasty in an Acromegalic Patient: A Case Report.

作者信息

Koulischer Simon, Kapanci Bilal, Bloemers Nicolas, Charles Tatiana, Jayankura Marc

机构信息

Department of Orthopaedic Surgery, ISPPC, Boulevard Zoé Drion 1, 6000 Charleroi, Belgium.

Department of Orthopaedic and Traumatologic Surgery, Erasme Hospital, Route de Lennik 808, 1070 Brussels, Belgium.

出版信息

J Orthop Case Rep. 2017 Mar-Apr;7(2):94-97. doi: 10.13107/jocr.2250-0685.768.

Abstract

INTRODUCTION

Acromegaly is a rare disorder characterized by excess secretion of growth hormone and its principle mediator, insulin-like growth factor-1. Although acromegaly is frequently associated with osteoarthritis, the outcome of arthroplasty in this population is not documented.

CASE REPORT

We report here a case of aseptic loosening of an uncemented total hip arthroplasty acetabulum in an acromegalic patient that was revised with a cemented cup. It has been suggested that the incidence of this complication is increased in other pathology with a similarly high bone-turnover (e.g., Paget's disease), but this complication has however not yet been reported in the setting of acromegaly.

CONCLUSION

Although coincidence cannot be ruled out, multiple metabolic hypotheses could account for an altered osseointegration process in the presence of acromegaly, which could lead to a higher risk of loosening.

摘要

引言

肢端肥大症是一种罕见的疾病,其特征是生长激素及其主要介质胰岛素样生长因子-1分泌过多。尽管肢端肥大症常与骨关节炎相关,但该人群中关节置换术的结果尚无文献记载。

病例报告

我们在此报告一例肢端肥大症患者非骨水泥型全髋关节置换髋臼无菌性松动的病例,该患者接受了骨水泥杯翻修术。有人认为,在其他具有类似高骨转换率的病理情况下(如佩吉特病),这种并发症的发生率会增加,但在肢端肥大症患者中尚未报告过这种并发症。

结论

尽管不能排除巧合,但多种代谢假说可以解释肢端肥大症患者骨整合过程改变的原因,这可能导致更高的松动风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0238/5553848/656e7053ef93/JOCR-7-94-g001.jpg

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