The painful metal-on-metal hip resurfacing
The painful metal-on-metal hip resurfacing
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DOI：
10.1302/0301-620x.91b6.21682
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发表时间：
2009-06-01
影响因子：
--
通讯作者：
Skinner, J. A.
中科院分区：
文献类型：
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作者：
Hart, A. J.;Sabah, S.;Skinner, J. A.
我们对 26 例金属对金属置换术后出现不明原因疼痛的患者进行了金属伪影还原 MRI、三维 CT 部件位置测量以及全血中钴和铬水平的电感耦合等离子体质谱分析。MRI 显示 16 个髋关节周围存在假体周围病变，其中 14 个积液和 2 个软组织肿块。男性和女性以及有症状和无症状的臀部均可见病变。通过三维CT，发现16例中的13例髋臼假体的中位倾角为55度，其位置位于Lewinnek安全区之外。使用电感耦合等离子体质谱法，与功能良好的金属对金属髋关节相比，疼痛时血液金属离子的水平往往更高。这三项临床上有用的研究可以帮助确定植入物失败的原因，预测未来修复的需要并帮助选择修复假体。
We carried out metal artefact-reduction MRI, three-dimensional CT measurement of the position of the component and inductively-coupled plasma mass spectrometry analysis of cobalt and chromium levels in whole blood on 26 patients with unexplained pain following metal-on-metal resurfacing arthroplasty.MRI showed periprosthetic lesions around 16 hips, with 14 collections of fluid and two soft-tissue masses. The lesions were seen in both men and women and in symptomatic and asymptomatic hips. Using three-dimensional CT, the median inclination of the acetabular component was found to be 55 and its positioning was outside the Lewinnek safe zone in 13 of 16 cases. Using inductively-coupled plasma mass spectrometry, the levels of blood metal ions tended to be higher in painful compared with well-functioning metal-on-metal hips.These three clinically useful investigations can help to determine the cause of failure of the implant, predict the need for future revision and aid the choice of revision prostheses.