Delayed dislocation following metal-on-polyethylene arthroplasty of the hip due to 'silent' trunnion corrosion.
Bone Joint J
; 98-B(2): 187-93, 2016 Feb.
Article
en En
| MEDLINE
| ID: mdl-26850423
AIMS: We present a case series of ten metal-on-polyethylene total hip arthroplasties (MoP THAs) with delayed dislocation associated with unrecognised adverse local tissue reaction due to corrosion at the trunnion and pseudotumour formation. METHODS: The diagnosis was not suspected in nine of the ten patients (six female/four male; mean age 66 years), despite treatment in a specialist unit (mean time from index surgery to revision was 58 months, 36 to 84). It was identified at revision surgery and subsequently confirmed by histological examination of resected tissue. Pre-operative assessment and culture results ruled out infection. A variety of treatment strategies were used, including resection of the pseudotumour and efforts to avoid recurrent dislocation. RESULTS: The rate of complications was high and included three deep infections, two patients with recurrent dislocation, and one recurrent pseudotumour. CONCLUSION: This series (mean follow-up of 76 months following index procedure and 19 months following revision THA) demonstrates that pseudotumour is an infrequent but important contributor to delayed instability following MoP THA. It is easy to overlook in the differential diagnosis, especially if the alignment of the components is less than optimal, leading to an assumption that malalignment is the cause of the dislocation. The instability is likely to be multifactorial and the revision surgery is complex. TAKE HOME MESSAGE: Due to the high complication rate associated with revision in this cohort, the diagnosis should be borne in mind when counselling patients regarding the risks of revision surgery.
Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Falla de Prótesis
/
Artroplastia de Reemplazo de Cadera
/
Luxación de la Cadera
/
Prótesis de Cadera
Tipo de estudio:
Etiology_studies
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Bone Joint J
Año:
2016
Tipo del documento:
Article
País de afiliación:
Canadá