Apple Andrew E, Montgomery Corey O, Mears Simon C
Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Arthroplast Today. 2021 Apr 14;8:211-215. doi: 10.1016/j.artd.2021.03.012. eCollection 2021 Apr.
Isolated patellar resurfacing served as an early treatment for patellofemoral arthritis but was abandoned because of erosion of the native femoral trochlear groove over time. We present the case of a large native tibial osteolytic lesion 20 years after isolated patellar resurfacing with a cemented polyethylene component. The patient had severe tricompartmental arthritic changes. The patellar component was very worn, and the resultant particle debris produced a large cavitary lesion in the proximal tibia. Osteolysis is a rare complication in patellofemoral arthroplasty, and, to our knowledge, this is the first reported case of native tibial osteolysis after isolated patellar resurfacing. The patient was treated with initial curettage and bone grafting of the lesion followed by total knee arthroplasty with a tibial cone and stemmed tibial fixation.
单纯髌骨表面置换术曾作为髌股关节炎的早期治疗方法，但由于随着时间推移天然股骨滑车沟出现侵蚀而被弃用。我们报告了1例在使用骨水泥固定的聚乙烯组件进行单纯髌骨表面置换术20年后出现巨大天然胫骨溶骨性病变的病例。该患者有严重的全膝关节骨性关节炎改变。髌骨组件磨损严重，由此产生的颗粒碎屑在胫骨近端形成了一个大的空洞性病变。骨溶解是髌股关节置换术中一种罕见的并发症，据我们所知，这是首例关于单纯髌骨表面置换术后天然胫骨骨溶解的报道病例。该患者最初接受了病变刮除和植骨治疗，随后进行了带胫骨锥和带柄胫骨固定的全膝关节置换术。
