From the Creighton University School of Medicine, Omaha, NE (Dr. Roesler), and the Department of Orthopaedic Surgery, University of Nebraska Medical Center, Omaha, NE (Dr. Garvin).
J Am Acad Orthop Surg Glob Res Rev. 2023 Mar 20;7(3). doi: 10.5435/JAAOSGlobal-D-22-00150. eCollection 2023 Mar 1.
A 73-year-old woman, 11 years after total hip arthroplasty and 2 years after a multilevel lumbar spine fusion, presented with a 2-month history of anterior hip and gluteal pain. She was diagnosed with an acetabular liner fracture that occurred through the high wall, likely related to repetitive impingement on the neck of the femoral implant, as notable burnishing was observed on the explanted femoral head. The acetabulum was successfully revised to a dual-mobility articulation. Spinal fusion after total hip arthroplasty can alter the acetabular implant position and was seen in our patient whose previously functional high-walled liner failed. Surgeons may consider alternative techniques, including a change in acetabular implant's anteversion to mitigate the need for a high-walled liner or the use of a dual-mobility bearing.
一位 73 岁女性，全髋关节置换术后 11 年，多节段腰椎融合术后 2 年，出现髋关节前部和臀部疼痛 2 个月。她被诊断为髋臼内衬骨折，发生在高壁处，可能与股骨植入物颈部的反复撞击有关，因为在取出的股骨头表面观察到明显的抛光。髋臼成功地修正为双动关节。全髋关节置换术后的脊柱融合会改变髋臼植入物的位置，我们的患者就出现了这种情况，其先前功能正常的高壁内衬失败了。外科医生可能会考虑替代技术，包括改变髋臼植入物的前倾角，以减轻对高壁内衬的需求，或使用双动轴承。
