Metal degradation products - A cause for concern in metal-metal bearings?
Metal degradation products - A cause for concern in metal-metal bearings?
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DOI：
10.1097/01.blo.0000096810.78689.62
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发表时间：
2003-12-01
影响因子：
4.2
通讯作者：
Urban, RM
中科院分区：
文献类型：
--
作者：
Jacobs, JJ;Hallab, NJ;Urban, RM
在大多数患者中，骨科植入物具有生物相容性。然而，越来越多的人认识到，从长远来看，永久性骨科植入物可能与某些个体的不良局部和远端组织反应有关。这些不良反应由植入物材料的降解产物介导。最近在全髋关节置换术中重新引入金属对金属关节面，加剧了对金属降解产物生物学反应的担忧，因为植入这些植入物的患者血清和尿液金属浓度通常高于传统金属对聚乙烯关节面患者。从以前的长期金属对金属McKee-Farrar种植体的研究来看，似乎这些升高的水平可能会持续种植体的使用寿命。这在更年轻和更活跃的患者中尤其值得关注，植入后的预期寿命可能超过30年。骨科植入物的金属释放与任何代谢、细菌学、免疫学或致癌毒性的相关性目前仍然是理论上的，因为尚未在人类受试者中确定因果关系。然而，需要继续监测金属植入物患者人群，特别是金属-金属关节面患者。
In the majority of patients, orthopaedic implants are biocompatible. However, there is an increasing recognition that, in the long-term, permanent orthopaedic implants may be associated with adverse local and remote tissue responses in some individuals. These adverse effects are mediated by the degradation products of implant materials. The recent reintroduction of metal-on-metal bearings for total hip arthroplasty has heightened concerns about the biologic response to metal degradation products in light of the fact that the serum and urine metal concentrations in patients with these implants typically are higher than those seen in patients with conventional metal-on-polyethylene bearings. From previous studies of long-term metal-on-metal McKee-Farrar implants, it seems that these elevated levels may persist for the duration of the implant's lifetime. This is of particular concern in the younger and more active patient in whom life expectancy after implantation may exceed 30 years. The association of metal release from orthopaedic implants with any metabolic, bacteriologic, immunologic, or carcinogenic toxicity currently remains conjectural because cause and effect have not been established in human subjects. However, continued surveillance of patient populations with metal implants, particularly those with metal-metal bearings, is warranted.