Metal on Metal Bearings: A Practical Alternative to Metal on Polyethylene Total Joints?
Metal on Metal Bearings: A Practical Alternative to Metal on Polyethylene Total Joints?
复制标题
金属对金属轴承：金属对聚乙烯全接头的实用替代方案？
DOI：
10.1097/00003086-199608001-00021
复制
发表时间：
1996
影响因子：
4.2
通讯作者：
J. Black
中科院分区：
文献类型：
--
作者：
J. Black
在全髋关节置换术中，金属对金属关节面被提议作为金属对聚合物关节面的替代品，作为减少磨损碎屑产生和随后导致需要手术翻修的骨质溶解的技术手段。金属对金属关节是否是当前实践的实际替代方案的问题本质上是它是否与使用超过20年的金属对聚合物关节一样安全且更有效。不幸的是，金属对金属关节面引入了与产生增加的金属腐蚀和磨损产物相关的额外生物风险。在Charnley型全髋关节置换术中，金属对聚合物关节的临床寿命和成功率是如此之高，以至于可能证明人类无法确定金属对金属关节更有效，即使客观上是这样。因此，根据现代技术和伦理标准，不能得出结论认为金属对金属关节是当前金属对聚合物设计的实际替代方案。这表明，未来全髋关节置换术结果的改善更可能是通过进化而不是革命性的设计。
Metal on metal articulation is proposed as an alternative to metal on polymer in total hip replacement arthroplasty as a technical means of reducing wear debris production and subsequent osteolysis leading to the need for surgical revision. The question of whether metal on metal articulation is a practical alternative to current practice is essentially that of whether it is as safe as, and more effective than, metal on polymer articulations in use for more than 20 years. Unfortunately, the metal on metal articulation introduces additional biologic risks associated with production of increased metallic corrosion and wear products. The clinical longevity and success of metal on polymer articulation in total hip replacements, as embodied in the Charnley type, is such that it may prove humanly impossible to determine that metal on metal articulations are more effective, even if that is objectively the case. Therefore, it is suggested that, consistent with modern technical and ethical standards, it cannot be concluded that metal on metal articulation is a practical alternative to current metal on polymer designs. It is suggested that future improvement in total hip replacement arthroplasty outcome is more likely to be through evolutionary than revolutionary designs.