Bone graft incorporation failure with inappropriate limb load transfer can lead to aseptic acetabular loosening of metal-on-metal prosthesis: A case report  

作　　者：RafałStanisław Domagalski Bogdan Dugiełło Sonia Rokicka Szymon Czech RafałSkowroński Dominika Rokicka Marta Patrycja Wróbel Krzysztof Strojek Tomasz Stołtny 

机构地区：[1]District Hospital of Orthopaedics and Trauma Surgery in PiekaryŚląskie,PiekaryŚląskie 41-940,Poland [2]District Railway Hospital,Medical University of Silesia,Katowice 40-760,Poland [3]Faculty of Medicine,Medical University of Gdańsk,Gdańsk 80-210,Poland [4]“ALFA”Orthopaedics and Traumatology Center,Białystok 15-763,Poland [5]Department of Internal Medicine,Diabetology and Cardiometabolic Disorders,Faculty of Medical Sciences Zabrze,Medical University of Silesia,Zabrze 41-800,Poland

出　　处：《World Journal of Orthopedics》2024年第7期668-674,共7页世界骨科杂志（英文版）

摘　　要：BACKGROUND Aseptic acetabular loosening can result from various factors that can be categorized into groups:patient-related,surgeon-related and implant-related.We present a case of a 63-year-old patient who at first underwent a total hip arthro-plasty(THA)using a metal-on-metal bearing due to hip arthrosis.Follow-up visits revealed no complications after the procedure.Two years after the THA,acetabular component loosening occurred due to subsequent trauma of the opposite hip,necessitating a revision THA using a ceramic-on-ceramic bearing.CASE SUMMARY We aim to illustrate a rare case where the primary reason for undergoing THA revision was not only incomplete bone graft incorporation but also improper limb load distribution.Following the revision arthroplasty,a 9-year follow-up visit revealed improvements in all evaluation measures on questionnaire compared to the state before surgery:Harris Hip Score(before surgery:15;after surgery:95),Western Ontario and McMaster Universities Arthritis Index(before surgery:96;after surgery:0),and Visual Analogue Scale(before surgery:10;after surgery:1).CONCLUSION Opposite-hip trauma caused a weight transfer to the limb after a THA procedure.This process led to a stress shielding effect,resulting in acetabular component loosening.

关 键 词：Acetabular loosening Limb load Stress shielding effect Revision hip arthroplasty Case report 

分 类 号：R687[医药卫生—骨科学]