Benevenia J, Lee F Y, Buechel F, Parsons J R
Department of Orthopaedics, New Jersey Medical School, Newark 07013, USA.
J Biomed Mater Res. 1998 Winter;43(4):473-7. doi: 10.1002/(sici)1097-4636(199824)43:4<473::aid-jbm16>3.0.co;2-9.
Wear debris of polyethylene, polymethylmethacrylate, and metal have been recognized to be associated with foreign body reactions, osteolysis, and aseptic prosthetic loosening after joint replacement arthroplasty. Further, foreign body reaction due to the presence of extensive wear debris can cause aggressive granulomatous lesions and pathologic fracture. To our knowledge, there has been no previous report of pathologic fracture of the femur due to an agressive pseudotumor. This report describes a case of pathologic supracondylar fracture of the femur 6 years and 5 months after cementless total knee replacement arthroplasty. The fracture occurred through an aggressive expanding soft tissue mass that was a tumorlike lesion secondary to polyethylene wear debris. The lesion was associated with massive osteolysis around the femoral component of the total knee prosthesis.
聚乙烯、聚甲基丙烯酸甲酯和金属的磨损碎屑已被认为与关节置换术后的异物反应、骨质溶解和无菌性假体松动有关。此外，大量磨损碎屑的存在引起的异物反应可导致侵袭性肉芽肿病变和病理性骨折。据我们所知，此前尚无因侵袭性假肿瘤导致股骨病理性骨折的报道。本报告描述了一例在非骨水泥全膝关节置换术后6年零5个月发生的股骨髁上病理性骨折病例。骨折发生于一个侵袭性扩大的软组织肿块，该肿块是继发于聚乙烯磨损碎屑的肿瘤样病变。该病变与全膝关节假体股骨组件周围的大量骨质溶解有关。
