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Metallosis following full thickness wear in total hip arthroplasty

机译:全髋关节置换术全厚度磨损后的金属病

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摘要

Extreme wear through the metal-backed acetabular cup following total hip arthroplasty is rare, as symptoms such as pain and disability will usually manifest earlier. We present the second reported case of extreme wear in a 78-year-old male patient, who presented 20 years following an uncemented total hip replacement with a 3-year history of hip pain, clicking on ambulation and worsening mobility. Radiographs demonstrated that the femoral head had migrated superolaterally through the polyethylene liner and the acetabular cup, and was articulating with the superior wall of the acetabulum causing bony destruction. Metallic fragments were also evident. A review of the current literature on metallosis suggests that should there be any clinical suspicion, blood metal ion levels are monitored and an MARS-MRI scan performed if indicated. If metallosis is detected, then revision surgery can be attempted at an earlier date, where the procedure is not as technically difficult.
机译:在全髋关节置换术后,金属支持的髋臼杯极度磨损是罕见的,因为疼痛和残疾等症状通常会更早地显现出来。我们介绍了第二例报道的一名78岁男性患者的极端磨损案例,该患者在进行非硬性全髋置换术后20年出现了3年的髋关节疼痛史,出现了下肢活动并加重了活动能力。放射线照片显示,股骨头已从聚乙烯衬垫和髋臼杯向上移位,并与髋臼上壁铰接,导致骨破坏。金属碎片也很明显。对有关金属化病的最新文献的回顾表明,如果有任何临床怀疑,应监测血液中的金属离子水平,并在必要时进行MARS-MRI扫描。如果检测到金属病,则可以在较早的日期尝试翻修手术,因为该手术在技术上并不困难。

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