Ｂｉｐｏｌａｒ型人工骨頭置換術後ｉｎｎｅｒ ｈｅａｄの脱臼を生じた２例
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概要
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We present two cases of inner head dislocation of a bipolar prosthesis with a self-centering system. In the first case, a 69-year-old man, a farmer, with bilateral steroid-induced aseptic necrosis of femoral heads underwent replacement of the bipolar prosthesis in 1991 (left) and 1993 (right). Stem loosening and cup migration in the right hip occurred 10 years after surgery. In 2002, he fell and the subsequent radiograph revealed the dislocation of the inner head. Total hip revision arthroplasty was carried out. A broken ring stopper and a large amount of polyethylene wear debris were found during the surgery. In the second case a 52-year-old man, a physical laborer, with bilateral alchoholic aseptic necrosis of the femoral head underwent replacement of the bipolar prosthesis in 1994 (left) and 1995 (right). In 2001, when he was working in half sitting position, severe right hip pain occurred, a radiograph taken at that time revealed the dislocation of the inner head. Acetabular socket revision was carried out. A broken bearing insert and a large amount polyethylene wear debris were also observed during the surgery. The key similarities observed in both cases are 1) acetabular reaming at first surgery, 2) large neck diameter of the femoral stem, 3) migration and varus fixation of the outer head, 4) physical labor. It is considered that these conditions induced poor oscillation of the inner head resulting in broken bearing insert and dislocation.
- 中国・四国整形外科学会の論文
中国・四国整形外科学会 | 論文
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