Koper M C, Mathijssen N M C, Witt F, Morlock M M, Vehmeijer S B W
Department of Orthopedics, Reinier de Graaf Hospital, Reinier de Graafweg 3, 2625 AD Delft, the Netherlands.
Biomechanics Section, Hamburg University of Technology, Denickestraße 15, 21073 Hamburg, Germany.
JBJS Case Connect. 2015 Apr 8;5(2):e29. doi: 10.2106/JBJS.CC.N.00104.
We describe the case of a seventy-six-year-old woman who had undergone bilateral total hip arthroplasty with Zweymüller-Metasul prostheses in 1996. After a fall sixteen years after the index procedures, radiographs suggested a taper fracture of the left total hip arthroplasty. However, revision surgery showed pseudotumor formation, with no evidence of taper fracture. Analysis of the prosthesis showed massive wear of the male stem taper caused by a mismatch between the stem taper and the head taper.
This case vividly demonstrates how taper size mismatch can cause dramatic metal wear and increased release of metal ions, resulting in pseudotumor formation.
我们描述了一位76岁女性的病例，她于1996年接受了双侧全髋关节置换术，使用的是Zweymüller-Metasul假体。在初次手术16年后摔倒后，X线片提示左全髋关节置换术出现锥形骨折。然而，翻修手术显示有假瘤形成，未发现锥形骨折的证据。对假体的分析表明，由于柄部锥度与头部锥度不匹配，导致柄部锥度出现大量磨损。
该病例生动地表明，锥度尺寸不匹配如何导致严重的金属磨损和金属离子释放增加，从而导致假瘤形成。
