Arvinte Dan, Kiran Manish, Sood Manoj
Department of Trauma and Orthopaedics, Bedford Hospital NHS Trust, South Wing, Kempston Road, Bedford MK42 9DJ, United Kingdom.
JBJS Case Connect. 2015 Apr 22;5(2):e35. doi: 10.2106/JBJS.CC.N.00146.
We report a rare case of modular femoral head-trunnion dissociation. The patient presented with a sudden onset of groin pain and an inability to bear weight. Intermittent clunking was reported to have started around five years after implantation of the hip replacement. The duration of symptoms, radiographic findings, and analysis of the retrieved components support the theory of chronic trunnion failure due to corrosion.
This is, to our knowledge, the first case of dissociation of the femoral head from the trunnion in which substantial macroscopic wear of the trunnion was observed and likely contributed to the dissociation. A new onset of clicking or clunking should be investigated as it may be a harbinger of head-neck dissociation.
我们报告一例罕见的模块化股骨头-耳轴分离病例。患者突发腹股沟疼痛且无法负重。据报告，髋关节置换植入术后约五年开始出现间歇性卡顿。症状持续时间、影像学表现以及对取出部件的分析支持了因腐蚀导致慢性耳轴失效的理论。
据我们所知，这是首例股骨头与耳轴分离且观察到耳轴有明显宏观磨损并可能导致分离的病例。新出现的弹响或卡顿应进行调查，因为它可能是头颈分离的先兆。
