全膝关节置换术后导致胫骨部件骨坏死和松动的胫骨骨内复苏
Intraosseous Tibial Resuscitation After a Total Knee Arthroplasty Leading to Osteonecrosis and Loosening of the Tibial Component.
作者信息
Wenzel Alyssa N, Auld Thomas, Bautista Anson, Huso Tait, Khanuja Harpal S
机构信息
Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Columbia University Vagelos College of Physicians and Surgeons, New York City, NY, USA.
出版信息
Arthroplast Today. 2023 Jan 14;19:101088. doi: 10.1016/j.artd.2022.101088. eCollection 2023 Feb.
A 51-year-old woman suffered cardiac arrest requiring emergent intraosseous access that abutted the tibial component of her total knee arthroplasty. She developed a wound at the site and knee pain which was concerning for deep infection. Subsequent imaging was consistent with osteonecrosis developing around the tibial component. The component eventually loosened, requiring a revision surgery. Her deep cultures remained negative throughout. Her findings are most consistent with osteonecrosis and aseptic loosening of her prosthesis. While intraosseous access may be beneficial during resuscitation, it has complications. This is the first reported case of osteonecrosis secondary to intraosseous access leading to prosthetic loosening necessitating a revision surgery.
一名51岁女性发生心脏骤停，需要紧急进行骨内通路穿刺，穿刺部位紧邻其全膝关节置换术的胫骨部件。她在该部位出现了伤口和膝关节疼痛，令人担心发生深部感染。后续影像学检查结果与胫骨部件周围发生的骨坏死相符。该部件最终松动，需要进行翻修手术。她的深部培养物始终呈阴性。她的检查结果最符合假体的骨坏死和无菌性松动。虽然骨内通路在复苏过程中可能有益，但也存在并发症。这是首例报告的因骨内通路继发骨坏死导致假体松动并需要翻修手术的病例。
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