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骨水泥型牛津假体股骨迁移导致关节脱位:两例报告。

Femoral migration of the cementless Oxford which caused the bearing dislocation: a report of two cases.

机构信息

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.

出版信息

BMC Musculoskelet Disord. 2020 Jun 8;21(1):356. doi: 10.1186/s12891-020-03385-0.

Abstract

BACKGROUND

There are no previous reports on the complications around the femoral component of cementless Oxford unicompartmental knee arthroplasty (UKA). However, we experienced two cases of femoral migration to the proximal side, which caused bearing dislocations after cementless Oxford UKA.

CASE PRESENTATION

Case1. In an 82-year-old woman, bearing dislocation occurred 13 months postoperatively because of femoral migration that was resolved with an revision surgery to cemented component and thicker mobile insert. Case2. In a 52-year-old man, first bearing dislocation occurred 7 months postoperatively. Five months after revising the insert to a thicker one, another dislocation occurred mainly because of the femoral migration. Eventually, a revision to total knee arthroplasty was necessary.

CONCLUSIONS

The inferred main reasons of femoral migration of cementless Oxford were osteoporosis for the first case and early return to high performance sports activity for the second case. Although several merits of using cementless prosthesis, particularly better fixation and lesser radiolucency than cemented prosthesis, have been reported, surgeons should pay attention to the patient's bone quality and advise a slow return to high-level physical activity.

摘要

背景

目前尚无关于非骨水泥 Oxford 单髁膝关节置换术(UKA)股骨部件周围并发症的报告。然而,我们遇到了两例股骨向近端迁移的病例,这导致了非骨水泥 Oxford UKA 后出现了轴承脱位。

病例报告

病例 1. 在一名 82 岁女性中,由于股骨迁移导致术后 13 个月发生了轴承脱位,通过对骨水泥固定组件和更厚的活动衬垫进行翻修手术解决了该问题。病例 2. 在一名 52 岁男性中,术后 7 个月首次发生了轴承脱位。在将衬垫更换为更厚的衬垫 5 个月后,再次发生脱位主要是因为股骨迁移。最终,需要进行全膝关节翻修术。

结论

推测非骨水泥 Oxford 股骨迁移的主要原因分别为骨质疏松(第一例)和过早恢复高体能运动(第二例)。尽管已经报道了使用非骨水泥假体的几个优点,特别是比骨水泥假体更好的固定和更少的射线透亮性,但外科医生应注意患者的骨质量,并建议缓慢恢复高水平的体力活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e3f/7282144/113fa61c0fa2/12891_2020_3385_Fig1_HTML.jpg

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