PDF(Pubmed)
Abstract：
UNASSIGNED: Posterior-stabilized (PS) total knee arthroplasty (TKA) prostheses are characterized by an articulation between the polyethylene tibial post and the cam of the femoral component. Tibial post-fractures, traumatic and non-traumatic, are uncommon but catastrophic complications. We report a rare and unusual case of complete atraumatic erosion of the tibial post after PS-TKA.
UNASSIGNED: We present a case of atraumatic tibial post-failure (complete erosion) in a 73-year-old female after primary TKA. The patient presented with chronic pain, effusion, and instability both in the coronal and sagittal plane over a period of 1 year. There were no signs of component loosening on plain radiography, no fractures, and revealed medial extension laxity on valgus stress views. During revision surgery, polyethylene insert retrieval revealed a completely eroded tibial post, without any obvious fracture. There was no fractured tibial post lying freely in the joint cavity. The patient was subsequently revised with a hinged component due to gross bi-planar instability.
UNASSIGNED: In a post-TKR (PS knee) patient with chronic pain and instability, one should consider tibial post-complications after ruling out infection. Chronic instability can cause progressive erosion of the tibial post, which can fail without an obvious fracture. Revision surgery with constrained implants may be needed to manage such cases.
UNASSIGNED: We present a case of atraumatic tibial post-failure (complete erosion) in a 73-year-old female after primary TKA. The patient presented with chronic pain, effusion, and instability both in the coronal and sagittal plane over a period of 1 year. There were no signs of component loosening on plain radiography, no fractures, and revealed medial extension laxity on valgus stress views. During revision surgery, polyethylene insert retrieval revealed a completely eroded tibial post, without any obvious fracture. There was no fractured tibial post lying freely in the joint cavity. The patient was subsequently revised with a hinged component due to gross bi-planar instability.
UNASSIGNED: In a post-TKR (PS knee) patient with chronic pain and instability, one should consider tibial post-complications after ruling out infection. Chronic instability can cause progressive erosion of the tibial post, which can fail without an obvious fracture. Revision surgery with constrained implants may be needed to manage such cases.
摘要：
■后稳定型（PS）全膝关节置换术（TKA）假体的特征在于聚乙烯胫骨柱与股骨部件的凸轮之间的铰接。胫骨骨折后,创伤和非创伤，是罕见但灾难性的并发症。我们报告了PS-TKA术后胫骨桩完全无创伤侵蚀的罕见病例。
■我们介绍了一名73岁女性初次TKA后胫骨无损伤后衰竭（完全侵蚀）的病例。病人出现慢性疼痛，积液,在1年的时间内，冠状面和矢状面都不稳定。平片上没有部件松动的迹象，没有骨折,并显示外翻应力视图的内侧伸展松弛。在翻修手术期间，聚乙烯插入件取回显示完全侵蚀的胫骨柱，没有任何明显的骨折。没有骨折的胫骨桩自由地躺在关节腔中。随后，由于严重的双平面不稳定性，患者进行了铰链部件的修正。
■在患有慢性疼痛和不稳定的TKR（PS膝盖）后患者中，排除感染后，应考虑胫骨术后并发症。慢性不稳定会导致胫骨桩进行性侵蚀，它可以在没有明显骨折的情况下失败。可能需要使用受限植入物的翻修手术来管理此类病例。
■我们介绍了一名73岁女性初次TKA后胫骨无损伤后衰竭（完全侵蚀）的病例。病人出现慢性疼痛，积液,在1年的时间内，冠状面和矢状面都不稳定。平片上没有部件松动的迹象，没有骨折,并显示外翻应力视图的内侧伸展松弛。在翻修手术期间，聚乙烯插入件取回显示完全侵蚀的胫骨柱，没有任何明显的骨折。没有骨折的胫骨桩自由地躺在关节腔中。随后，由于严重的双平面不稳定性，患者进行了铰链部件的修正。
■在患有慢性疼痛和不稳定的TKR（PS膝盖）后患者中，排除感染后，应考虑胫骨术后并发症。慢性不稳定会导致胫骨桩进行性侵蚀，它可以在没有明显骨折的情况下失败。可能需要使用受限植入物的翻修手术来管理此类病例。
