Psychiatric Disorders and Genotoxicity Following Primary Metal on Polyethylene Total Hip Arthroplasty and Their Correlation to Cobalt/Chromium Levels.
Psychiatric Disorders and Genotoxicity Following Primary Metal on Polyethylene Total Hip Arthroplasty and Their Correlation to Cobalt/Chromium Levels.
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DOI：
10.2147/dhps.s360643
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发表时间：
2022
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使用植入式金属部件的髋关节置换术 (HA) 是最常见的骨科干预措施之一。然而，腐蚀和金属离子释放可能会导致一些并发症。多项研究证明，受损的基因组 DNA 可能导致精神障碍的病理生理学。目前的工作旨在评估金属聚乙烯髋关节置换术 (MOP-HA) 患者的精神疾病及其与钴/铬 (Co/Cr) 水平和遗传毒性的相关性。这项工作是一项纵向随访研究，包括 34 名符合纳入和排除标准的单侧原发性 MOP-HA 成人。术前、术后6、12个月，使用简易精神状态检查（MMSE）检查患者的认知障碍，使用重度抑郁量表（MDI）检查抑郁情况，并收集血样用于Co/Cr估计，通过单细胞凝胶电泳（彗星测定）和血清8-羟基-2'-脱氧鸟苷（8-OHdG）检测遗传毒性。术后 6 个月和 12 个月出现认知障碍的比例分别为 18.5% 和 14.8%。术后 6 个月和 12 个月时，抑郁症的发生率分别为 22.2% 和 14.8%。边际同质性检验证明差异不显着。术前、术后6个月、12个月MMSE和MDI评分无显着差异。术后 6 个月 Co/Cr 水平显着升高。然而，术后 12 个月时该水平有所下降，但仍显着高于术前值。术后6个月和12个月血清8-OHdG显着升高，且其水平与钴水平呈正相关。术前、术后 6 个月和 12 个月的彗星试验测量值之间没有显着差异。根据之前的研究结果，我们可以得出结论，具有意志功能的 MOP 髋关节置换术可以诱导离子水平升高，并且与基因毒性生化标志物 (8-OHdG) 呈正相关增加。
Hip arthroplasty (HA) using implantable metal components is among the commonest orthopedic interventions. However, it can be followed by several complications following corrosion and the release of metal ions. Several studies proved that damaged genomic DNA may contribute to the pathophysiology of mental disorders. The current work aims to evaluate the psychiatric disorders in metal on polyethylene hip arthroplasty (MOP-HA) patients and its correlation to cobalt/chromium (Co/Cr) levels and genotoxicity. The work was a longitudinal follow-up study including 34 adults with unilateral primary MOP-HA meeting the inclusion and exclusion criteria. Preoperatively, 6, 12-months-postoperatively, patients were examined for cognitive impairment using mini-mental-state-examination (MMSE), depression using major-depressive-inventory (MDI), and blood samples were collected for estimation of Co/Cr, detection of genotoxicity by single-cell-gel-electrophoresis (comet assay) and serum 8-hydroxy-2’–deoxyguanosine (8-OHdG). Cognitive impairment was reported in 18.5% and 14.8% at 6-months, and 12-months postoperative, respectively. Depressive disorder was recorded in 22.2% at 6-months and 14.8% at 12-months postoperative. The marginal homogeneity tests proved a non-significant difference. There was a non-significant difference in preoperative, 6-months, 12-months postoperative MMSE, and MDI scores. There were significantly increased Co/Cr levels at 6-months postoperative. The levels decreased at 12-months postoperative, however, still significantly higher than preoperative values. There was a significant increase in serum 8-OHdG and the levels were positively correlated to cobalt levels at both 6 and 12-months-postoperative. There was a non-significant difference among preoperative, 6-months, and 12-months postoperative comet assay measurements. From previous findings, we can conclude that will-functioning MOP hip arthroplasty can induce increased ion levels and positively correlated increase in biochemical markers of genotoxicity (8-OHdG).