Clinical, radiological, histological and retrieval findings of Activ-L and Mobidisc total disc replacements: a study of two patients.
Clinical, radiological, histological and retrieval findings of Activ-L and Mobidisc total disc replacements: a study of two patients.
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Activ-L 和 Mobidisc 全椎间盘置换术的临床、放射学、组织学和检索结果：对两名患者的研究。
DOI：
10.1007/s00586-011-2141-7
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
vanOoij,Andre
中科院分区：
文献类型：
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作者：
Austen,Shennah;Punt,IlonaM;Cleutjens,JackPM;Willems,PaulC;Kurtz,StevenM;MacDonald,DanielW;vanRhijn,LodewijkW;vanOoij,Andre
简介本研究评估了两名第二代腰椎全椎间盘置换术 (TDR) 患者的短期临床结果、放射学、组织学和器械回收结果。材料和方法第一名患者接受单级 L4-L5 Activ-L TDR，第二名患者接受 L4-L5 Mobidisc 和 L5-S1 Activ-L TDR。 TDR植入其他部位，植入时间在1.3至2.8年之间。结果平片和CT扫描显示两名患者的Activ-L TDR都有轻微下沉，小关节退变。由于背部和腿部反复疼痛，患者接受了翻修手术。去除 TDR 和后外侧融合后，疼痛有所改善。组织学检查显示 Mobidisc 周围回收的组织中有大量超高分子量聚乙烯 (UHMWPE) 颗粒和巨细胞。 Activ-L TDR 组织样本中的颗粒较小并且包含在巨噬细胞中。 UHMWPE 芯材的检索分析显示，两种 TDR 设计中都存在轻微的粘着磨损和磨粒磨损，并带有撞击迹象。 结论 尽管磨损与修订原因无关，但本研究表明第二代 TDR 中存在 UHMWPE 颗粒和炎症细胞。 TDR 后需要进行长期随访，以监测磨损和种植体状态。
IntroductionThis study evaluates the short-term clinical outcome, radiological, histological and device retrieval findings of two patients with second generation lumbar total disc replacement (TDR).Materials and methodsThe first patient had a single level L4-L5 Activ-L TDR, the second patient a L4-L5 Mobidisc and L5-S1 Activ-L TDR. The TDRs were implanted elsewhere and had implantation times between 1.3 and 2.8 years.ResultsPlain radiographs and CT-scanning showed slight subsidence of the Activ-L TDR in both patients and facet joint degeneration. The patients underwent revision surgery because of recurrent back and leg pain. After removal of the TDR and posterolateral fusion, the pain improved. Histological examination revealed large ultrahigh molecular weight polyethylene (UHMWPE) particles and giant cells in the retrieved tissue surrounding the Mobidisc. The particles in the tissue samples of the Activ-L TDR were smaller and contained in macrophages. Retrieval analysis of the UHMWPE cores revealed evidence of minor adhesive and abrasive wear with signs of impingement in both TDR designs.ConclusionAlthough wear was unrelated to the reason for revision, this study demonstrates the presence of UHMWPE particles and inflammatory cells in second generation TDR. Long-term follow-up after TDR is indicated for monitoring wear and implant status.