Are Metal Ion Levels a Useful Trigger for Surgical Intervention?
Are Metal Ion Levels a Useful Trigger for Surgical Intervention?
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DOI：
10.1016/j.arth.2012.03.020
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发表时间：
2012-09-01
影响因子：
3.5
通讯作者：
Dennos, Anne C.
中科院分区：
文献类型：
--
作者：
Griffin, William L.;Fehring, Thomas K.;Dennos, Anne C.
本研究的目的是确定钴和铬离子水平是否可以预测全髋关节翻修时的软组织损伤。本研究纳入了90例术前钴和铬离子水平的金属对金属全髋关节患者。在翻修手术中发现的组织损伤按4分制进行分级。计算不同阈值的敏感性、特异性和预测值。对接收机工作特性进行了分析。以7 ppb作为阈值，钴和铬离子水平的敏感性和特异性较差（Co为65%和56%；Cr为29%和75%）。对钴和铬的阳性预测值分别只有48%和26%。曲线下面积为0.37的钴和0.44的铬。修复时间与组织损伤显著相关（P = 0.001）。离子水平是关节周围软组织损伤的不可靠的预测因素，不应单独用作手术干预的触发因素。
The purpose of this study was to determine if cobalt and chromium ion levels can predict soft tissue damage at total hip revision. This study included 90 metal-on-metal total hip patients with preoperative cobalt and chromium ion levels. Tissue damage noted at revision surgery was graded on a 4-point scale. Sensitivity, specificity, and predictive values were calculated for various threshold values. Receiver operating characteristic analysis was conducted. Using 7 ppb as a threshold, cobalt and chromium ion levels had poor sensitivity and specificity (Co, 65% and 56%; Cr, 29% and 75%). Positive predictive values for cobalt and chromium were only 48% and 26% respectively. The area under the curve was 0.37 for cobalt and 0.44 for chromium. The length of time to revision significantly correlated with tissue damage (P = .001). Ion levels are unreliable predictors of periarticular soft tissue damage and should not be used in isolation as surgical intervention triggers.