Peterson Jonathan R, Wright Timothy M, Wellman Samuel S, Lachiewicz Paul F
Department of Orthopaedic Surgery, Duke University, Durham, NC, USA.
Hospital for Special Surgery, New York, NY, USA.
Arthroplast Today. 2019 Mar 7;5(1):52-56. doi: 10.1016/j.artd.2019.01.006. eCollection 2019 Mar.
This is the first report, to our knowledge, of a fracture, unrelated to trunnion corrosion, through the midneck of a well-fixed uncemented cobalt-chromium alloy femoral component that had been implanted via a total hip revision arthroplasty 25 years ago. Three years after a second revision for polyethylene wear, the patient noted an acute onset of pain in the left hip. There was no antecedent pain in the hip or thigh. Radiographs and intraoperative findings showed a well-fixed femoral component. Electron microscopic retrieval analysis showed intergranular material cracks. Revision of the femoral component was performed with an extended trochanteric osteotomy. This fracture of the femoral component neck was likely related to metal fabrication techniques, and surveillance of this component may be warranted.
据我们所知,这是首例通过全髋关节翻修置换术植入的、固定良好的非骨水泥钴铬合金股骨部件中颈部发生骨折的报告,该骨折与耳轴腐蚀无关,该部件于25年前植入。在因聚乙烯磨损进行二次翻修三年后,患者注意到左髋部急性疼痛发作。髋部或大腿此前并无疼痛。X线片和术中检查结果显示股骨部件固定良好。电子显微镜取出分析显示晶间材料裂纹。采用大转子延长截骨术对股骨部件进行翻修。股骨部件颈部的这种骨折可能与金属制造技术有关,可能有必要对该部件进行监测。