Reddy Hemant, Zvi Yoav, Weiser Mitchell
Department of Orthopedic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.
Arthroplast Today. 2023 Mar 9;20:101106. doi: 10.1016/j.artd.2023.101106. eCollection 2023 Apr.
Adverse local tissue reaction (ALTR) is a frequently described, although uncommon, complication of metal-on-metal total hip arthroplasty. Here in we report on 2 patients with unique metal-inlay polyethylene liners who suffered from ALTR that required revision arthroplasty. In 2 of 3 cases the femoral trunnion was noted to have minimal corrosion and the stem was salvaged with a titanium adapter. In one case there was catastrophic femoral stem failure and an extended trochanteric osteotomy was required to remove the unique lateral flare stem. The surgeon must pay special attention when scrutinizing radiographs to identify a metal inlay polyethylene liner and when performing revision arthroplasty to prevent greater trochanter fracture in a patient who likely already has compromised abductor function due to ALTR.
不良局部组织反应（ALTR）是金属对金属全髋关节置换术一种虽不常见但常被描述的并发症。在此，我们报告2例使用独特金属镶嵌聚乙烯内衬的患者，他们患有需要翻修置换术的ALTR。在3例中的2例中，发现股骨柄有轻微腐蚀，通过钛制适配器挽救了股骨柄。在1例中，发生了灾难性的股骨干失败，需要进行大转子延长截骨术以取出独特的外侧扩口柄。外科医生在仔细检查X线片以识别金属镶嵌聚乙烯内衬时，以及在进行翻修置换术时，必须特别注意，以防止在因ALTR可能已经存在外展肌功能受损的患者中发生大转子骨折。
