Farrier Adam James, Holland Jim
Trauma and Orthopaedics, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, Tyne and Wear, UK
Trauma and Orthopaedics, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, Tyne and Wear, UK.
BMJ Case Rep. 2021 Apr 26;14(4):e241523. doi: 10.1136/bcr-2020-241523.
Here, we present an interesting case of seroma following hip resurfacing arthroplasty in a 69-year-old man. During the postoperative recovery, the patient made rapid progress and returned to intense activity within the 6-week period. He subsequently developed further right hip pain and swelling. On further examination and on ultrasound scan, a lateral thigh collection was noted. All inflammatory markers were within normal parameters; clinically, there was no evidence of active infection. On initial aspiration and washout, there was a large sterile haemoserous collection. The patient subsequently underwent further aspiration due to persistent collection. After this a revision procedure was performed in two stages with excision of the seroma cavity superficial to fascia lata. Methicillin-sensitive was grown on extended cultures which was treated successfully with antibiotics. After the second stage revision to total hip replacement, this cavity then recollected. A further trial of aspiration with injection of 200 mg doxycycline, a known sclerosing agent, was performed. The seroma resolved.
在此，我们呈现一例69岁男性髋关节表面置换术后出现血清肿的有趣病例。术后恢复期间，患者进展迅速，并在6周内恢复了高强度活动。随后，他右侧髋关节出现进一步疼痛和肿胀。进一步检查及超声扫描发现大腿外侧有积液。所有炎症指标均在正常范围内；临床上，无活动性感染迹象。初次穿刺冲洗时，发现有大量无菌血性浆液性积液。由于积液持续存在，患者随后接受了进一步穿刺。此后，分两阶段进行了翻修手术，切除阔筋膜浅层的血清肿腔。延长培养后培养出对甲氧西林敏感的[细菌名称未给出]，使用抗生素成功治疗。在第二阶段翻修至全髋关节置换术后，该腔隙再次积液。又进行了一次穿刺试验，注射了200mg多西环素（一种已知的硬化剂）。血清肿消退。
