Weidenhielm Lars, Olivecrona Henrik, Maguire Gerald Q, Noz Marilyn E
Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
School of Information and Communication Technology, KTH Royal Institute of Technology, Stockholm, Sweden.
Skeletal Radiol. 2018 Jun;47(6):883-887. doi: 10.1007/s00256-018-2878-8. Epub 2018 Jan 23.
This case report follows a woman who had a total hip replacement in 1992 when she was 45 years old. Six serial computed tomography (CT) examinations over a period of 13 years provided information that allowed her revision surgery to be limited to liner replacement as opposed to replacement of the entire prosthesis. Additionally, they provided data that ruled out the presence of osteolysis and indeed none was found at surgery. In 2004, when the first CT was performed, the 3D distance the femoral head had penetrated into the cup was determined to be 2.6 mm. By 2017, femoral head penetration had progressed to 5.0 mm. The extracted liner showed wear at the thinnest part to be 5.5 mm, as measured with a micrometer. The use of modern CT techniques can identify problems, while still correctable without major surgery. Furthermore, the ability of CT to assess the direction of wear revealed that the liner wear changed from the cranial to dorsal direction.
本病例报告讲述了一位女性，她于1992年45岁时接受了全髋关节置换术。在13年的时间里进行的6次连续计算机断层扫描（CT）检查提供了相关信息，使得她的翻修手术仅限于更换内衬，而非更换整个假体。此外，这些检查提供的数据排除了骨溶解的存在，并且在手术中确实未发现骨溶解。2004年进行首次CT检查时，确定股骨头穿入髋臼杯的三维距离为2.6毫米。到2017年，股骨头穿入距离已进展至5.0毫米。取出的内衬用千分尺测量，最薄处磨损为5.5毫米。使用现代CT技术能够识别问题，且在无需进行大手术的情况下仍可纠正。此外，CT评估磨损方向的能力显示，内衬磨损方向从颅侧变为背侧。
