Changes in blood ion levels after removal of metal-on-metal hip replacements: 16 patients followed for 0-12 months.
Changes in blood ion levels after removal of metal-on-metal hip replacements: 16 patients followed for 0-12 months.
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DOI：
10.3109/17453674.2014.913223
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发表时间：
2014-06
影响因子：
3.7
通讯作者：
Hart AJ
中科院分区：
文献类型：
--
作者：
Durrani SK;Noble PC;Sampson B;Panetta T;Liddle AD;Sabah SA;Chan NK;Skinner JA;Hart AJ
在金属对金属(MOM)髋关节假体患者中，疼痛和关节积液可能与血液中钴和铬离子水平升高有关。由于对金属离子从体内清除的动力学和升高的血液离子水平的消退率知之甚少，我们研究了翻修MOM髋关节置换术后钴和铬离子水平的时间进程。我们包括16名患者(13名女性)，他们接受了疼痛的母亲髋关节(大直径，现代轴承)的翻修，没有骨折或感染，翻修后平均6.1(0-12)个月内至少进行了4次血液金属离子测量。修订时的平均血液离子浓度铬为22 ppb，钴为43 ppb。翻修手术后离子水平的变化在不同患者之间差异很大。在许多情况下，在翻修手术后的第二个月和第三个月内，离子水平下降到翻修时测量值的50%。铬水平的下降比钴水平的下降发生得更慢，恢复到正常水平有9%的滞后。两种金属的衰变速率都遵循二级(指数)动力学，而不是一级(线性)动力学。疼痛的母亲髋关节置换术后患者血液中钴和铬的排出遵循指数衰减曲线，半衰期约为50天。修订后，血液中钴和铬离子水平的升高可以持续至少一年，特别是在高暴露水平的患者中。
In patients with metal-on-metal (MoM) hip prostheses, pain and joint effusions may be associated with elevated blood levels of cobalt and chromium ions. Since little is known about the kinetics of metal ion clearance from the body and the rate of resolution of elevated blood ion levels, we examined the time course of cobalt and chromium ion levels after revision of MoM hip replacements. We included 16 patients (13 female) who underwent revision of a painful MoM hip (large diameter, modern bearing) without fracture or infection, and who had a minimum of 4 blood metal ion measurements over an average period of 6.1 (0–12) months after revision. Average blood ion concentrations at the time of revision were 22 ppb for chromium and 43 ppb for cobalt. The change in ion levels after revision surgery varied extensively between patients. In many cases, over the second and third months after revision surgery ion levels decreased to 50% of the values measured at revision. Decay of chromium levels occurred more slowly than decay of cobalt levels, with a 9% lag in return to normal levels. The rate of decay of both metals followed second-order (exponential) kinetics more closely than first-order (linear) kinetics. The elimination of cobalt and chromium from the blood of patients who have undergone revision of painful MoM hip arthroplasties follows an exponential decay curve with a half-life of approximately 50 days. Elevated blood levels of cobalt and chromium ions can persist for at least 1 year after revision, especially in patients with high levels of exposure.
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DOI：
10.1302/0301-620x.91b2.21654
发表时间：
2009-02-01
影响因子：
--
作者：
Daniel, J.;Ziaee, H.;McMinn, D. J. W.
通讯作者：
McMinn, D. J. W.
DOI：
10.1302/0301-620x.90b7.20213
发表时间：
2008-07-01
影响因子：
--
作者：
Pandit, H.;Glyn-Jones, S.;Murray, D. W.
通讯作者：
Murray, D. W.
影响因子：
4.2
作者：
Campbell, Pat;Ebramzadeh, Edward;Nelson, Scott;Takamura, Karren;De Smet, Koen;Amstutz, Harlan C.
通讯作者：
Amstutz, Harlan C.
DOI：
10.1302/0301-620x.93b10.26249
发表时间：
2011-10-01
影响因子：
--
作者：
Hart, A. J.;Sabah, S. A.;Skinner, J. A.
通讯作者：
Skinner, J. A.
影响因子：
4.2
作者：
Corradi, Massimo;Daniel, Joseph;McMinn, Derek J. W.
通讯作者：
McMinn, Derek J. W.