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首页> 外文期刊>Orthopedics >Paresis of the Peroneal Nerve: A Rare But Severe Long-term Complication of Polyethylene Wear in Knee Arthroplasty
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Paresis of the Peroneal Nerve: A Rare But Severe Long-term Complication of Polyethylene Wear in Knee Arthroplasty

机译：细胞神经的谱系：膝关节置换术中聚乙烯磨损的罕见但严重的长期并发症

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One of the most important limiting factors in the long-term success of total knee arthroplasty is polyethylene wear. Particles of the polyethylene inserts have been shown to elicit a foreign body response, which produces bone resorption and osteolysis, ultimately leading to loosening and component failure. The authors report on a case of an elderly patient who underwent a total knee arthroplasty almost 2 decades ago. Clinical and radiological checkups of the knee had not been performed recently. He now presented with a painful and swollen knee, recurrent joint effusion and swelling of the lower leg, and paresis of the peroneal nerve. Radiological examination showed asymmetric wear of the polyethylene insert and pronounced periprosthetic osteolysis of the proximal tibia and the distal femur. Furthermore, a large ganglion on the anterolateral aspect of the lower leg, resulting in pressure on the peroneal nerve, was detected on ultrasound examination. Open excision of the ganglion was performed initially, followed by 1-stage revision knee arthroplasty using a modular system a few weeks later. This case shows a rare but severe long-term complication of total knee arthroplasty and highlights the importance of regular clinical and radiological checkups after total joint replacements, even for asymptomatic patients and especially in the long term (ie, beyond 10 years after implantation). The current case shows that wear of the polyethylene insert may also lead to ganglion formation that causes paresis of the peroneal nerve.
机译：长期成功的总膝关节置换术的最重要限制因素之一是聚乙烯磨损。已经显示聚乙烯插入物的颗粒以引发异物反应，其产生骨吸收和骨解，最终导致松动和成分衰竭。作者报告了一个老年患者的案例，近几十年前经历了全膝关节置换术。膝关节的临床和放射学检查尚未均未进行。他现在患有疼痛且肿胀的膝盖，反复性的关节积液和小腿的肿胀，并对腓骨神经进行肿胀。放射检查显示近端胫骨和远端股骨的聚乙烯插入物的不对称磨损。此外，在小腿的前腿前部的大神经节，在超声检查上检测到细胞神经压力。最初进行神经节的开放切除，然后在几周后使用模块化系统，然后使用模块化系统进行1级修正膝关节置换术。这种情况表明，全膝关节置换术的罕见但严重的长期并发症，凸显了常规临床和放射学检查的重要性，即使是无症状患者，尤其是长期（即植入后10年）。当前情况表明，聚乙烯插入件的磨损也可能导致神经节形成，导致腓骨神经的破碎。

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