Ponomarjova Eleonora, Jakovicka Darta, Studers Peteris
Department of Orthopaedics, Faculty of Medicine, Riga Stradins University, Riga, Latvia.
Joint Laboratory of Traumatology and Orthopaedics, Riga Stradins University, Riga, Latvia.
J Orthop Case Rep. 2023 Feb;13(2):25-29. doi: 10.13107/jocr.2023.v13.i02.3542.
Periprosthetic osteolysis (PPOL) is a serious complication after total hip replacement and requires immediate action to prevent further spread to nearby tissues and has the opportunity to restore hip function successfully. We present the case of PPOL of a patient with a challenging course of treatment.
We report a 75-year-old patient with PPOL that spreads to the soft tissues and pelvic region 14 years after primary total hip arthroplasty. At all stages of treatment, an elevated neutrophil-dominant cell count was detected in the analysis of synovial fluid aspiration of the left hip joint without detection of microbiological culture. Due to severe bone loss and general patient condition, no further surgical treatment was indicated, and there is no clear vision of future actions.
Management of severe PPOL can be challenging, as there are limited surgical treatment options with a good long-term prognosis. If an osteolytic process is suspected, it should be treated as soon as possible to avoid more severe progression of the complications.
人工关节周围骨溶解（PPOL）是全髋关节置换术后的一种严重并发症，需要立即采取行动以防止其进一步扩散至附近组织，并争取成功恢复髋关节功能。我们报告了一例治疗过程具有挑战性的PPOL患者病例。
我们报告了一名75岁的PPOL患者，在初次全髋关节置换术后14年，骨溶解扩散至软组织和骨盆区域。在治疗的各个阶段，对左髋关节滑膜液抽吸物进行分析时，均检测到以中性粒细胞为主的细胞计数升高，而微生物培养未检测到异常。由于严重的骨质流失和患者的总体状况，未进行进一步的手术治疗，且对未来的行动尚无明确规划。
严重PPOL的管理具有挑战性，因为具有良好长期预后的手术治疗选择有限。如果怀疑存在骨溶解过程，应尽早进行治疗，以避免并发症更严重的进展。
