Kobayashi S, Takaoka K, Tsukada A, Ueno M
Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Arch Orthop Trauma Surg. 1998;117(6-7):390-1. doi: 10.1007/s004020050274.
A 33-year-old woman underwent an uncemented bipolar hip arthroplasty for osteoarthrosis of the left hip in 1985. Because of painful aseptic loosening, the bipolar implant was revised to a total hip prosthesis in 1994. Membranous tissues around the implant histologically presented foreign-body reaction against polyethylene debris. The retrieved implant showed polyethylene wear of the rim of the bipolar cup. Three-dimensional measurement of the surface configuration of the polyethylene of the cup indicated that wear debris had been generated almost exclusively from femoral bipolar neck-cup impingement. Volumetric wear in the articulating dome portion of the polyethylene was negligible. This report clearly illustrates how impingement of a bipolar cup on the femoral neck can be a major source of polyethylene wear debris which induces femoral osteolysis and subsequent stem loosening.
一名33岁女性于1985年因左髋骨关节炎接受了非骨水泥型双极髋关节置换术。由于疼痛性无菌性松动，1994年将双极植入物翻修为全髋关节假体。植入物周围的膜状组织在组织学上表现出对聚乙烯碎片的异物反应。取出的植入物显示双极杯边缘有聚乙烯磨损。对杯状聚乙烯表面形态的三维测量表明，磨损碎片几乎完全是由股骨双极颈杯撞击产生的。聚乙烯关节穹顶部分的体积磨损可忽略不计。本报告清楚地说明了双极杯对股骨颈的撞击如何成为聚乙烯磨损碎片的主要来源，进而导致股骨骨溶解和随后的柄部松动。
