Koike Hiroshi, Ikuta Kunihiro, Urakawa Hiroshi, Sakai Tomohisa, Fujito Takeo, Nishida Yoshihiro, Imagama Shiro
Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya University Hospital, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan.
Department of Advanced Medicine, Nagoya University Hospital, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan.
J Med Case Rep. 2025 Jan 8;19(1):6. doi: 10.1186/s13256-024-05012-1.
The Compress is designed to achieve bone formation and stability by applying pressure at the bone-implant interface, minimizing the likelihood of aseptic loosening, which is a complication of stem implants. Herein, we report two cases of implant failure using the Compress.
Case 1 describes a 36 year-old Japanese man who underwent extraarticular tumor resection, Compress arthroplasty, and reconstruction with a gastrocnemius flap after preoperative chemotherapy for a secondary malignant giant cell tumor in the right distal femur. Postoperatively, partial weight-bearing was started at 6 weeks, and full weight-bearing was allowed at 10 weeks. One year after the surgery, a fall caused implant failure. No bone formation at the implant-bone interface was observed on radiographs immediately prior to the failure. Bone formation was achieved at the interface 1 year after revision arthroplasty, and the patient was able to walk unassisted with a brace. Case 2 describes a 14 year-old Japanese boy who underwent wide surgical resection of osteosarcoma in the left tibia, Compress arthroplasty, and reconstruction with a gastrocnemius flap after preoperative chemotherapy. The postoperative weight-bearing schedule was the same as that of case 1. One year after the surgery, the patient experienced implant failure. A revision arthroplasty was performed. One year after revision surgery, the patient was able to walk unassisted.
Although the risk factors for Compress failure remain unknown, it is important to consider patient characteristics that may inhibit bone formation, implant selection, postoperative loading timing, and radiographs of bone formation at the implant interface when using the Compress.
Compress旨在通过在骨-植入物界面施加压力来实现骨形成和稳定性，从而将无菌性松动的可能性降至最低，无菌性松动是干植入物的一种并发症。在此，我们报告两例使用Compress的植入物失败病例。
病例1描述了一名36岁的日本男性，他因右股骨远端继发性恶性巨细胞瘤在术前化疗后接受了关节外肿瘤切除、Compress关节成形术以及腓肠肌瓣重建术。术后，6周开始部分负重，10周允许完全负重。手术后一年，一次跌倒导致植入物失败。失败前即刻的X线片显示植入物-骨界面未形成骨。翻修关节成形术后1年，界面处实现了骨形成，患者能够在佩戴支具的情况下独立行走。病例2描述了一名14岁的日本男孩，他在术前化疗后接受了左胫骨骨肉瘤的广泛手术切除、Compress关节成形术以及腓肠肌瓣重建术。术后负重计划与病例1相同。手术后一年，患者出现植入物失败。进行了翻修关节成形术。翻修手术后一年，患者能够独立行走。
尽管Compress失败的危险因素尚不清楚，但在使用Compress时，考虑可能抑制骨形成的患者特征、植入物选择、术后负重时机以及植入物界面处骨形成的X线片非常重要。
