Segura J, Palanca D, Bueno A L, Seral B, Castiella T, Seral F
Servicio de Traumatología y Cirugía Ortopédica, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
Chir Organi Mov. 1996 Sep-Dec;81(4):421-6.
It is our belief that this is the first histologically documented case of popliteal cyst secondary to early failure of a cementless knee prosthesis, that occurred after 4 years. The walls of the cyst presented with granulomatous reaction to polyethylene particles. In prosthetic reimplantation successive to excision of the cyst we observed a recurrence of cysts and osteointegration of the prosthetic components, that made reimplantation difficult. Histological assessment of the synovial tissue, periprosthetic tissue and underlying bone showed granulomatous reaction to polyethylene debris. A "tumor" in a patient that has a knee prosthesis can be caused by implant failure. In cases of early failure wear forms large particles and their migration at the bone-prosthesis interface may be obstructed and thus cause a different biological response. If reimplantation is necessary osteointegration of the implants may make surgery difficult.
我们认为，这是首例组织学记录的继发于非骨水泥型膝关节假体早期失败（发生于4年后）的腘窝囊肿病例。囊肿壁对聚乙烯颗粒呈现出肉芽肿反应。在囊肿切除后继发的假体再植入过程中，我们观察到囊肿复发以及假体组件的骨整合，这使得再植入变得困难。对滑膜组织、假体周围组织及下方骨骼的组织学评估显示对聚乙烯碎片有肉芽肿反应。膝关节假体患者出现的“肿瘤”可能由植入物失败引起。在早期失败的情况下，磨损会形成大颗粒，它们在骨 - 假体界面的迁移可能受阻，从而引发不同的生物学反应。如果有必要进行再植入，植入物的骨整合可能会使手术变得困难。
