The clinical implications of metal debris release from the taper junctions and bearing surfaces of metal-on-metal hip arthroplasty JOINT FLUID AND BLOOD METAL ION CONCENTRATIONS
The clinical implications of metal debris release from the taper junctions and bearing surfaces of metal-on-metal hip arthroplasty JOINT FLUID AND BLOOD METAL ION CONCENTRATIONS
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DOI：
10.1302/0301-620x.98b7.37029
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发表时间：
2016-07-01
影响因子：
4.6
通讯作者：
Langton, D. J.
中科院分区：
文献类型：
--
作者：
Sidaginamale, R. P.;Joyce, T. J.;Langton, D. J.
我们希望研究金属碎片暴露对金属对金属（MoM）髋关节置换术后免疫反应和软组织损伤的影响。一些报告表明，从头颈锥连接产生的碎片是更具破坏性的比等效剂量从金属轴承surfaces.Patients和MethodsWe调查的来源和体积的金属碎片对铬（Cr）和钴（Co）的影响。在相应的血液和髋关节滑液样品中的浓度和切除组织中观察到的团聚颗粒尺寸，使用多元回归分析，收集的数据。共199例翻修的MoM髋关节（177例患者; 132髋（女性）结果统计模型表明，来自锥形连接的金属碎屑的较大来源贡献与局部组织中较小的聚集颗粒尺寸和相应滑液中Cr离子浓度的相对降低有关和血液样本从锥形接头产生的金属碎片似乎是一个不同的形态，组成，因此，潜在的，免疫原性产生的轴承surfaces.ConclusionThe产生的碎片从锥形和关节面的差异可能会提供一些了解的软组织反应的发病率增加的报告，在植入MoM全髋关节置换术的患者相比，髋关节表面置换术。
AimsWe wished to investigate the influence of metal debris exposure on the subsequent immune response and resulting soft-tissue injury following metal-on-metal (MoM) hip arthroplasty. Some reports have suggested that debris generated from the head-neck taper junction is more destructive than equivalent doses from metal bearing surfaces.Patients and MethodsWe investigated the influence of the source and volume of metal debris on chromium (Cr) and cobalt (Co) concentrations in corresponding blood and hip synovial fluid samples and the observed agglomerated particle sizes in excised tissues using multiple regression analysis of prospectively collected data. A total of 199 explanted MoM hips (177 patients; 132 hips female) were analysed to determine rates of volumetric wear at the bearing surfaces and taper junctions.ResultsThe statistical modelling suggested that a greater source contribution of metal debris from the taper junction was associated with smaller aggregated particle sizes in the local tissues and a relative reduction of Cr ion concentrations in the corresponding synovial fluid and blood samples. Metal debris generated from taper junctions appears to be of a different morphology, composition and therefore, potentially, immunogenicity to that generated from bearing surfaces.ConclusionThe differences in debris arising from the taper and the articulating surfaces may provide some understanding of the increased incidence of soft-tissue reactions reported in patients implanted with MoM total hip arthroplasties compared with patients with hip resurfacings.