Herndon Carl L, Shah Roshan P, Cooper H John, Geller Jeffrey A
The Center for Hip and Knee Replacement, Columbia University Department of Orthopedic Surgery, New York, NY, USA.
Arthroplast Today. 2018 Jun 20;4(3):261-265. doi: 10.1016/j.artd.2018.05.003. eCollection 2018 Sep.
Mechanically assisted crevice corrosion (MACC), also known as trunnionosis, and adverse local tissue reaction (ALTR) are entities that can lead to pain and necessitate revision in total hip arthroplasty (THA). We present a case of a 75-year-old female who received a bilateral staged primary THA with metal on cross-linked polyethylene implants and had subsequent bilateral revisions for MACC and ALTR. In both instances, she presented with anterior thigh pain, weakness, and difficulty ambulating, and she was revised to ceramic on cross-linked polyethylene implants. This case may suggest a biologic predisposition or systemic immunogenic reaction to metal debris in some patients with ALTR or represent an implant-specific complication. To our knowledge, this is the first case reported of a patient having bilateral MACC from staged THA performed by 2 different surgeons using the same brand implant.
机械辅助缝隙腐蚀（MACC），也称为耳轴病，以及不良局部组织反应（ALTR）是可导致疼痛并需要对全髋关节置换术（THA）进行翻修的情况。我们报告一例75岁女性病例，该患者接受了双侧分期初次THA，使用金属对交联聚乙烯植入物，随后因MACC和ALTR进行了双侧翻修。在这两种情况下，她均出现大腿前部疼痛、无力和行走困难，翻修为陶瓷对交联聚乙烯植入物。该病例可能提示部分ALTR患者对金属碎屑存在生物学易感性或全身免疫原性反应，或代表一种植入物特异性并发症。据我们所知，这是首例报道的由两位不同外科医生使用同一品牌植入物进行分期THA后出现双侧MACC的患者。
