陶对陶全髋置换后炎性假瘤并脱位:1例报告和综述

Inflammatory pseudotumor accompanied with hip dislocation secondary to ceramic on ceramic total hip arthroplasty:acase report and review

本文报道了1例陶对陶(ceramic on ceramic,CoC)全髋置换术(total hip arthroplasty,THA)后炎性假瘤(inflammatory pseudotumor,IP)并发髋关节后脱位的患者,该患者CoC THA术后8年,因深蹲致左髋关节假体脱位,闭合复位7次失败后采用切开复位术治疗,切开后见陶瓷球头存在线性磨损,将髋臼杯及四周数十枚IP取出后将股骨假体成功复位。通过对该病例的分析,作者认为尽管CoC假体磨损率低且所产生的陶瓷颗粒生物活性极差,较少引起细胞反应及炎症的发生,但其并不完全是惰性的,可能会导致不良局部组织反应(adverse local tissue reaction,ALTR)及IP的发生。此外,本文通过文献回顾,着重介绍CoC THA术后IP出现的原因、早期诊断及治疗方法,旨在为临床提供参考。

This paper reports a case of inflammatory pseudotumor(IP)complicated with posterior dislocation of the hip after ceramic onceramic(CoC)total hip arthroplasty(THA).Eight years after CoC THA,the patient had left hip prosthesis dislocated due to squatting,and re-ceived open reduction finally following 7 failed closed reduction.The linear wear of ceramic ball was found after open exposure,and then thehip was reduced successfully after dozens of IP lesions were removed around the acetabular components.Through the analysis of this case,we believe that although the wear rate of CoC prosthesis is low with very low biological activity of the ceramic particles,which rarely causescell reaction and inflammation,they are not completely inert,and may cause adverse local tissue reaction(ALTR)and IP.In addition,by lit-erature review,this paper focuses on the causes,early diagnosis and treatment of IP after CoC THA in order to provide clinical reference.