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相關文獻
- Failure of the Locking Mechanism between the Acetabular Metal Shell and the Polyethylene Liner after Primary Total Hip Arthroplasty--A Case Report
- Two to Five Year Follow-Up of Harris-Galante Cementless Total Hip Arthroplasty
- Only Cup Revision of Infected Total Hip Arthroplasty with Antiprotrusio Cage in a Patient with Pelvic Discontinuity for Three Years Follow-up
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題 名 | Failure of the Locking Mechanism between the Acetabular Metal Shell and the Polyethylene Liner after Primary Total Hip Arthroplasty--A Case Report=人工全髖關節置換術後之髖臼金屬外殼與聚乙烯內襯間之固鎖裝置失效一病例報告 |
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作 者 | 陳正彥; 黃冠諭; 張瑞根; 林高田; 林森源; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷 期 | 16:7 2000.07[民89.07] |
頁 次 | 頁368-374 |
分類號 | 416.61 |
關鍵詞 | 人工全髖關節置換術; 髖臼金屬外殼; 聚乙烯內襯; 固鎖裝置; Total hip replacement; Polyethylene dissociation; Modular prosthesis; Locking mechanism; |
語 文 | 英文(English) |
中文摘要 | Harris-Galante II之具孔洞性表面塗層處理,不需骨水泥固定之人工髖臼 的短、中期臨床及影像學結果大多非常優良,然而它的組合設計也引致髖臼金屬 外殼與聚乙烯內襯之間固鎖裝置失效的潛在危險。髖臼金屬外殼的邊緣有四對固 鎖叉齒,用來固定聚乙烯內襯。任何固鎖叉齒的變形或斷裂皆會導致金屬外殼與 聚乙烯內襯之間的穩定度下降甚或發生內襯脫離。國外之文獻上曾有九例固鎖叉 齒斷裂的報導。但在台灣文獻上卻未曾發表過。我們報告一個病例在經過一個初 次人工全髖關節置換術後5年,於一次輕微創傷後發現一段叉齒斷裂的情形。再 次手術時發現聚乙烯內襯的外層表面與金屬外殼之下端叉齒接觸的部位有刮傷 的現象。雖然沒有內襯脫離,但在由金屬外殼中取出內襯時發現剩存的固鎖裝置 已相當鬆弛。我們認為HG II的髖臼組合杯的固鎖裝置可能在力學上較為脆弱; 且不需經重大創傷即可能失效。因為它的設計可能需再加以改進以避免術後之聚 乙烯內襯脫離。 |
英文摘要 | The short and intermediate-term clinical and radiographic results associated with Harris-Galante II porous-coated acetabular modular cup without cementing have been excellent in most patients. Nevertheless, its modular design introduced the potential for failure of the locking mechanism. There are four pairs of locking tines on the rim of metal shell to fix the polyethylene liner within it. Failure of any locking tine would result in less rigid fixation between the metal shell and the polyethylene liner and potentially produce instability or even disassembling of the liner. Only nine cases have been reported previously aboutthe fractures of the locking tine, but it has never been reported in literature in Taiwan.We report a case with fracture of one tine following minor trauma at five years after primary total hip arthroplasty. During reoperation, scratching injury on the outer surface of the polyethylene liner in contact with the inferior tines of the metal shell was noted. Although no disassembling of the liner was noted, the remaining locking mechanism was found to be less rigid when the liner was taken out of the shell. The locking mechanism of HG II cup may be mechanically weak and may fail without major trauma; therefore, its design ought to be improved in an attempt to prevent postoperative dissociation of the polyethylene liner. |
本系統中英文摘要資訊取自各篇刊載內容。