Long-term follow-up of metal-on-metal total hip replacement
Long-term follow-up of metal-on-metal total hip replacement
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DOI：
10.1002/jor.20381
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发表时间：
2007-07-01
影响因子：
2.8
通讯作者：
Kotz, Rainer
中科院分区：
文献类型：
--
作者：
Gruebl, Alexander;Marker, Martina;Kotz, Rainer
重新引入金属对金属关节以减少聚乙烯颗粒引起的骨溶解。在短期和中期随访中发现血清金属水平升高。人们对离子金属生成增加的长期影响知之甚少。我们的研究旨在提供金属对金属髋关节假体至少10年随访后的长期生存、临床结果、影像学表现和血清金属浓度的信息：98例平均年龄56岁的患者植入了105个具有金属对金属关节面的无水泥一期全髋关节假体。临床资料，x线片和血液样本在植入后10年的随访中获得。用原子吸收光谱法测定血清钴、铬水平。一般实验室分析包括全血细胞计数和肾功能参数。10年后，哈里斯的得分是92分，加州大学洛杉矶分校的得分是6分。在Gruen的1、7、8和14区发现小的溶骨病变和放射线线。生存率为98.6%。22例髋关节置换术患者的血清钴浓度中位数为0.75 μ g/L（范围0.3-50.1 μ g/L）。在研究期间，没有患者被诊断为肾功能不全。5例患者在手术至随访期间被诊断为恶性肿瘤。我们没有原发性恶性肿瘤发生率增加的证据，也没有在我们的研究组中发现肾功能衰竭。血清金属水平与短期和中期随访值无差异。(c) 2007年骨科研究学会。Wiley期刊公司出版。
Metal-on-metal articulations were reintroduced to reduce polyethylene particle-induced osteolysis. Elevated serum metal levels have been detected at short- and intermediate-term follow-up. There is little knowledge about long-term effects of increased ionic metal generation. Our study was undertaken to provide information about long-term survival, clinical outcome, radiographic appearance, and serum metal concentrations after a minimum 10 years follow-up with a metal-on-metal hip prosthesis: 105 cementless primary total hip prostheses with metal-on-metal articulating surfaces were implanted in 98 patients with a mean age of 56 years. Clinical data, radiographs, and blood samples were obtained at a follow-up visit 10 years after implantation. Serum cobalt and chromium levels were determined with use of atomic absorption spectrometry. General laboratory analyses included a full blood count and kidney function parameters. The Harris score was 92 points and the UCLA score 6 points after 10 years. Small osteolytic lesions and radiolucent lines were found in Gruen's zones 1, 7, 8, and 14. The probability of survival was 98.6%. The median serum cobalt concentration of the 22 patients with their hip replacement as the only source of cobalt was 0.75 mu g/L (range, 0.3-50.1 mu g/L). No patient was diagnosed with renal insufficiency during the study period. Five patients were diagnosed with a malignancy between surgery and the follow-up. We do not have evidence of an increased rate of primary malignancies nor could we detect renal failure in our study group. Serum metal levels did not differ from short- and intermediate term follow-up values. (c) 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.