Pseudotumours associated with metal-onmetal hip resurfacings
Pseudotumours associated with metal-onmetal hip resurfacings
复制标题
DOI：
10.1302/0301-620x.90b7.20213
复制
发表时间：
2008-07-01
影响因子：
--
通讯作者：
Murray, D. W.
中科院分区：
文献类型：
--
作者：
Pandit, H.;Glyn-Jones, S.;Murray, D. W.
我们报告了17例患者（20髋），他们进行了金属对金属表面置换，并表现出各种症状和软组织肿块，我们称之为假肿瘤。每位患者均行x线平片检查，部分患者还行CT、MRI和超声检查。此外，对现有样本进行组织学检查。所有患者都是女性，她们的表现各不相同。最常见的症状是髋部不适。其他症状包括自发性脱位、神经麻痹、明显肿块或皮疹。常见的组织学特征是广泛的坏死和淋巴细胞浸润。到目前为止，20个髋关节中有13个需要对传统的髋关节置换术进行修改。其中两项正在等待修订。我们估计大约有1%的患者在五年内进行了金属对金属表面修复，并发展为假肿瘤。病因不明，可能是多因素的。过量的颗粒金属磨损碎片可能会产生毒性反应，或对正常数量的金属碎片产生超敏反应。我们担心随着时间的推移，这些假肿瘤的发病率可能会增加。需要进一步调查以确定其原因。
We report 17 patients (20 hips) in whom metal-on-metal resurfacing had been performed and who presented with various symptoms and a soft-tissue mass which we termed a pseudotumour. Each patient underwent plain radiography and in some, CT, MRI and ultrasonography were also performed. In addition, histological examination of available samples was undertaken.All the patients were women and their presentation was variable. The most common symptom was discomfort in the region of the hip. Other symptoms included spontaneous dislocation, nerve palsy, a noticeable mass or a rash. The common histological features were extensive necrosis and lymphocytic infiltration. To date, 13 of the 20 hips have required revision to a conventional hip replacement. Two are awaiting revision.We estimate that approximately 1% of patients who have a metal-on-metal resurfacing develop a pseudotumour within five years. The cause is unknown and is probably multifactorial. There may be a toxic reaction to an excess of particulate metal wear debris or a hypersensitivity reaction to a normal amount of metal debris. We are concerned that with time the incidence of these pseudotumours may increase. Further investigation is required to define their cause.