Park J Patrick, Nooh Anas, Tayara Bader, Jung Sungmi, Turcotte Robert
Department of Orthopaedic Surgery, McGill University Health Center, Montreal, Quebec, Canada.
Department of Pathology, McGill University Health Center, Montreal, Quebec, Canada.
Arthroplast Today. 2021 Jan 30;7:161-166. doi: 10.1016/j.artd.2020.12.017. eCollection 2021 Feb.
Limited literature exists on complications specific to the all-polyethylene tibial component in distal femoral replacement (DFR). Unlike in primary arthroplasty with polyethylene components, polyethylene granuloma has not been reported in DFR with an all-polyethylene tibia. Here, we report 2 cases of polyethylene granuloma in patients with primary bone sarcoma who underwent DFR with an all-polyethylene tibia. Radiologically, evidence of intraosseous granuloma formation and periprosthetic osteolysis was observed at the anterior tibial metaphysis. Both patients underwent an operative debridement of polyethylene granuloma and necrotic tissues, followed by a revision to a long-stem, cemented metal-backed tibia with impacted allograft to fill the defect. Polyethylene granuloma should be considered a differential diagnosis in the presence of a periprosthetic lytic lesion after DFR with an all-polyethylene tibial component.
关于全聚乙烯胫骨部件在股骨远端置换术（DFR）中特有的并发症的文献有限。与使用聚乙烯部件的初次关节置换术不同，在采用全聚乙烯胫骨的DFR中尚未报道过聚乙烯肉芽肿。在此，我们报告2例原发性骨肉瘤患者在接受采用全聚乙烯胫骨的DFR后发生聚乙烯肉芽肿的病例。在放射学上，观察到胫骨近端干骺端有骨内肉芽肿形成和假体周围骨溶解的迹象。两名患者均接受了聚乙烯肉芽肿和坏死组织的手术清创，随后翻修为带骨水泥的长柄金属背衬胫骨，并植入骨移植填充物以填补缺损。在采用全聚乙烯胫骨部件的DFR后出现假体周围溶骨性病变时，应考虑将聚乙烯肉芽肿作为鉴别诊断。
