模块化膝关节假体股骨柄-干骺端套筒连接处的失效与疲劳骨折：一例报告
Failure and Fatigue Fracture at the Femoral Stem-Metaphyseal Sleeve Junction in a Modular Knee Prosthesis: A Case Report.
作者信息
Christiner Tom, Pabbruwe Moreica B, Kuster Markus
机构信息
Department of Medical Engineering and Physics, Centre for Implant Technology and Retrieval Analysis, Royal Perth Hospital, Perth, Australia.
Perth Orthopaedic and Sports Medicine Centre, West Perth, Western Australia, Australia.
出版信息
JBJS Case Connect. 2018 Jul-Sep;8(3):e67. doi: 10.2106/JBJS.CC.17.00320.
CASE
A 66-year-old active man had undergone revision total knee replacement surgery with a femoral metaphyseal sleeve and a cemented stem in 2013 after loosening of the implant following the primary knee arthroplasty. He was overweight and had a high activity level, and there had been progressive osteolysis surrounding the distal aspect of the femoral sleeve. In 2017, the metaphyseal sleeve had loosened, resulting in corrosion of the threaded taper and catastrophic failure of the implant, with a fracture of the stem at the junction of the sleeve.
CONCLUSION
This unique method of failure in this knee implant highlights a weak point in the design. Clinicians must be aware of the increased likelihood of this type of failure with these implants in patients who have contributory factors.
病例
一名66岁的活跃男性在初次膝关节置换术后植入物松动，于2013年接受了使用股骨干骺端套筒和骨水泥柄的全膝关节置换翻修手术。他超重且活动量较大，股骨套筒远端周围出现了进行性骨质溶解。2017年，干骺端套筒松动，导致螺纹锥腐蚀，植入物灾难性失效，柄在套筒连接处发生骨折。
结论
这种膝关节植入物独特的失效方式凸显了设计中的一个薄弱点。临床医生必须意识到，对于有促成因素的患者，使用这些植入物时发生此类失效的可能性会增加。
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