Zanotti Gerardo, Slullitel Pablo Ariel, Comba Fernando Martín, Buttaro Martín Alejandro, Piccaluga Francisco
Hip Surgery Unit, Institute of Orthopaedics "Carlos E. Ottolenghi", Italian Hospital of Buenos Aires, 4247 Potosí St., C1199ACK Buenos Aires, Argentina.
SICOT J. 2017;3:52. doi: 10.1051/sicotj/2017038. Epub 2017 Sep 5.
Complex regional pain syndrome (CRPS) constitutes an atypical cause of pain after orthopaedic procedures. To our knowledge, there is a paucity of literature reporting this syndrome after total hip arthroplasty (THR), since only two case reports have been published. We thenceforth describe the clinical outcome of three cases of type-1 CRPS developed after elective THR, two of them initially diagnosed with secondary osteoarthritis whereas the remaining one presented a sequel of a failed osteosynthesis that required conversion to THR. Remission of disease was found at an average seven months (range: 4-9). Medical treatment involved a combined therapy of pain management, bisphosphonates and intense physical therapy. One patient was additionally treated with a corticosteroid blockade of his right sympathetic lumbar ganglia. None of the patients required surgical treatment. At final follow-up, physical examinations and imaging were negative for disease.
复杂性区域疼痛综合征（CRPS）是骨科手术后疼痛的一种非典型病因。据我们所知，关于全髋关节置换术（THR）后出现该综合征的文献报道很少，因为仅发表了两篇病例报告。此后，我们描述了三例择期THR后发生的1型CRPS的临床结果，其中两例最初诊断为继发性骨关节炎，另一例是骨固定失败后需要转为THR的后遗症。平均七个月（范围：4 - 9个月）时病情缓解。药物治疗包括疼痛管理、双膦酸盐和强化物理治疗的联合疗法。一名患者还接受了右侧腰交感神经节的皮质类固醇阻滞治疗。所有患者均无需手术治疗。在最后一次随访时，体格检查和影像学检查均未发现疾病迹象。
