Baker Emma, French Cristy, Brian Pamela, Thomas Jonelle, Davis Charles M
Department of Radiology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.
Department of Orthopaedics and Rehabilitation, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.
Arthroplast Today. 2021 Feb 9;7:230-234. doi: 10.1016/j.artd.2020.12.015. eCollection 2021 Feb.
Trunnionosis is emerging as an early mode of failure in conventional metal-on-polyethylene total hip arthroplasty. It is defined as wear or corrosion at the trunnion, the taper at the femoral head-neck interface. Trunnion wear can result in a variety of negative sequelae and, in severe cases, necessitate revision arthroplasty. We describe a 64-year-old man with a metal-on-polyethylene total hip arthroplasty who presented with a sensation of clunking in the hip. Initial imaging and laboratory studies were inconclusive, and the decision was made to monitor. Two years later, trunnion wear was detected on radiographs, presenting as an abnormal alignment of the femoral neck relative to the femoral head. Several case reports and series describe catastrophic total hip arthroplasty failure due to trunnionosis. However, few describe the radiographic signs of wear at the trunnion before gross failure. This early presentation is important to recognize to minimize patient morbidity and aid surgical planning.
在传统的金属对聚乙烯全髋关节置换术中，轴颈磨损正成为一种早期失败模式。它被定义为轴颈处（股骨头 - 颈界面的锥形部分）的磨损或腐蚀。轴颈磨损可导致多种不良后果，在严重情况下，需要进行翻修关节成形术。我们描述了一名64岁接受金属对聚乙烯全髋关节置换术的男性，他出现了髋关节卡顿感。最初的影像学和实验室检查结果不明确，于是决定进行监测。两年后，X线片上检测到轴颈磨损，表现为股骨颈相对于股骨头的异常对线。几例病例报告和系列研究描述了因轴颈磨损导致的灾难性全髋关节置换术失败。然而，很少有研究描述在严重失败之前轴颈磨损的影像学征象。认识到这种早期表现对于将患者发病率降至最低并辅助手术规划很重要。
