后外侧入路髋关节翻修术中发现聚乙烯内衬磨损断裂1例并文献复习

A case of wear and fracture of polyethylene lining found in posterolateral approach hip revision and literature review

南京中医药大学附属医院收治1例右侧全髋关节置换术(THA)后疼痛患者,入院后经综合诊断予行后外侧入路髋关节翻修术。术前采用AIHIP系统进行术前设计,术中发现聚乙烯内衬磨损、断裂,但其髋臼臼杯骨长入良好,异常牢固,于是采取打磨臼杯内面,植入聚乙烯内衬,用骨水泥固定的方法进行翻修,而没有将股骨头、内衬和髋臼侧假体全部更换。手术顺利,术后患者恢复良好,治愈出院。常规聚乙烯材料内衬损耗约为20年,该患者术后8年将内衬磨穿、断裂,且未造成假体进一步松动,较为特殊。该研究就其断裂原因和治疗翻修方法展开讨论,交流手术、治疗方法及注意事项,并回顾相关文献。

A patient with pain after right total hip arthroplasty(THA) in the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine was recorded.The patient conducted the posterolateral approach hip revision by comprehensive diagnosis after admission.The AIHIP system was used for preoperative design.During the operation,it was found that the polyethylene liner was worn and broken,but the bone of the acetabular cup was well inserted and extremely firm.Therefore,the internal surface of the acetabular cup was polished,the polyethylene liner was implanted,and the revision was performed by using bone cement fixation,instead of all replacement of the femoral head,lining and acetabular side prosthesis.The operation was successful,the patient recovered well after the operation,and was cured and discharged.The loss of conventional polyethylene material lining is about 20 years,and the lining of this patient was worn through and broken in 8 years after surgery without further loosening of the prosthesis,which was relatively special.In this study,the causes of rupture and treatment revision methods were discussed,surgery,treatment methods and precautions were exchanged,and relevant literature was reviewed.