Zink Thomas M, McGrory Brian J
Tufts University School of Medicine, Boston, MA, USA.
Maine Medical Center, Division of Joint Replacements, Portland, ME, USA.
Arthroplast Today. 2020 Jun 25;6(3):445-450. doi: 10.1016/j.artd.2020.04.015. eCollection 2020 Sep.
Mechanically assisted crevice corrosion in modular total hip replacements may lead to an adverse local tissue reaction (ALTR) with a variety of sequelae. Although an ALTR is most commonly recognized with metal-on-metal modular hip constructs, tribocorrosion at the head-neck junction of metal-on-polyethylene (MoP) total hip arthroplasties may also lead to an ALTR. We present a case of a 79-year-old woman with a history of MoP total hip arthroplasty who presented with unilateral leg swelling, joint pain, and stiffness and subsequently underwent revision for an ALTR secondary to mechanically assisted crevice corrosion. This unique case of lower extremity vascular compromise resulting from an ALTR is important because clinicians should consider corrosion-related ALTRs when treating patients with an MoP hip prosthesis presenting with new-onset lower extremity swelling.
模块化全髋关节置换术中的机械辅助缝隙腐蚀可能会导致不良局部组织反应(ALTR)并引发多种后遗症。虽然ALTR最常见于金属对金属的模块化髋关节结构,但金属对聚乙烯(MoP)全髋关节置换术的头颈交界处的摩擦腐蚀也可能导致ALTR。我们报告了一例79岁女性患者,有MoP全髋关节置换术病史,出现单侧腿部肿胀、关节疼痛和僵硬,随后因机械辅助缝隙腐蚀继发的ALTR而接受翻修手术。这例由ALTR导致下肢血管受损的独特病例很重要,因为临床医生在治疗出现新发下肢肿胀的MoP髋关节假体患者时,应考虑与腐蚀相关的ALTR。