Argyria following the use of silver-coated megaprostheses NO ASSOCIATION BETWEEN THE DEVELOPMENT OF LOCAL ARGYRIA AND ELEVATED SILVER LEVELS
Argyria following the use of silver-coated megaprostheses NO ASSOCIATION BETWEEN THE DEVELOPMENT OF LOCAL ARGYRIA AND ELEVATED SILVER LEVELS
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DOI：
10.1302/0301-620x.95b7.31124
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发表时间：
2013-07-01
影响因子：
4.6
通讯作者：
Tunn, P-U.
中科院分区：
文献类型：
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作者：
Glehr, M.;Leithner, A.;Tunn, P-U.
这项研究的目的是评估银涂层巨型假体患者局部银质缺乏的发生率，并确定银质缺乏与局部和血液中银水平升高之间的可能联系。2004至2011年间，20名女性和12名男性患者因感染或恶性肿瘤切除而进行了关节翻修手术，植入了32个镀银涂层的巨型假体，并测定了局部引流管、血清和血液中的银水平。患者的平均年龄为46岁(10-81岁)，1例患者在术后即刻死亡并被排除在外。7名患者(23%)在中位时间25.7个月(四分位数范围2-44.5)后发展为局灶性银屑病。患有和不伴有局灶性银中毒的患者在血液和吸液中的银水平相当。种植体长度对局部银屑病的发生无明显影响。有临床证据的局部银屑病患者没有神经系统症状，也没有肾或肝衰竭的证据。因此，我们得出结论，没有必要对这些患者的血液银水平进行短期监测。
The aims of this study were to evaluate the incidence of local argyria in patients with silver-coated megaprostheses and to identify a possible association between argyria and elevated levels of silver both locally and in the blood. Between 2004 and 2011, 32 megaprostheses with silver coatings were implanted in 20 female and 12 male patients following revision arthroplasty for infection or resection of a malignant tumour, and the levels of silver locally in drains and seromas and in the blood were determined. The mean age of the patients was 46 years (10 to 81); one patient died in the immediate post-operative period and was excluded.Seven patients (23%) developed local argyria after a median of 25.7 months (interquartile range 2 to 44.5). Patients with and without local argyria had comparable levels of silver in the blood and aspiration fluids. The length of the implant did not influence the development of local argyria. Patients with clinical evidence of local argyria had no neurological symptoms and no evidence of renal or hepatic failure. Thus, we conclude that the short-term surveillance of blood silver levels in these patients is not required.