Synovial Fluid Metal Ion Levels are Superior to Blood Metal Ion Levels in Predicting an Adverse Local Tissue Reaction in Failed Total Hip Arthroplasty.
Synovial Fluid Metal Ion Levels are Superior to Blood Metal Ion Levels in Predicting an Adverse Local Tissue Reaction in Failed Total Hip Arthroplasty.
复制标题
在预测全髋关节置换术失败的局部组织不良反应方面，滑液金属离子水平上级于血液金属离子水平。
DOI：
10.1016/j.arth.2021.04.034
复制
发表时间：
2021-09
影响因子：
3.5
通讯作者：
Berry, Daniel J.
中科院分区：
文献类型：
--
作者：
Houdek, Matthew T.;Taunton, Michael J.;Wyles, Cody C.;Jannetto, Paul J.;Lewallen, David G.;Berry, Daniel J.
不良局部组织反应与金属对金属(MOM)轴承患者的全髋关节置换术(THA)失败和/或锥形腐蚀有关，后者也可发生在金属对聚乙烯(MOP)关节中。患者接受血液钴(Co)和铬(Cr)浓度的监测，但这并不总是与术后软组织反应的程度相关。这项研究的目的是确定血液和假体髋关节滑液中钴和铬的水平如何相互关联，并确定哪种浓度更能预测ALTR。26例人工全膝关节置换术患者(n=26)和27例非人工关节置换术患者(n=27)在进行人工全关节置换术时采集滑液和血液样本。全血、血清和滑液中金属离子浓度与临床表现呈正相关。ALTR型和非ALT型髋关节滑液与全血钴浓度之比分别为12 0：1和18：1(P=0.006)。ALTR型和非ALT型髋关节滑液与全血铬浓度的平均比值分别为414：1和24：1(P=0.01)。关节液中钴/铬浓度分别为2,007.3 ppb与12.4 ppb(P=0.007)和3,188.2 ppb与10.3 ppb(P=0.02)。滑液钴浓度是检测ALTR值最准确的指标(截断值：19.75PPB，AUC 0.973)。在ALTR患者中，滑液中的钴和铬分别是全血钴和铬的120倍和414倍。滑液钴离子浓度是预测ALTR值最准确的指标。
Adverse local tissue reactions (ALTR) are associated with total hip arthroplasty (THA) failure in patients with metal-on-metal (MoM) bearings and/or taper corrosion, which can also occur in metal-on-polyethylene (MoP) articulations. Patients are monitored with blood cobalt (Co) and chromium (Cr) concentrations which do not always correlate with the degree of soft-tissue reaction at revision THA. The purpose of this study was to determine how the blood and prosthetic hip synovial fluid levels of Co and Cr correlate with one another, and determine which concentration is more predictive of ALTR. Synovial fluid and blood samples were collected at the time of revision THA in patients with (n=26) and without ALTR (n=27). Whole blood, serum and synovial fluid metal ion concentrations were correlated with one another and clinical findings. The ratio of synovial fluid to whole blood Co concentration in ALTR and non-ALTR hips was 120:1 and 18:1 (p=0.006). The mean ratio of synovial fluid to whole blood Cr concentration in ALTR and non-ALTR hips was 414:1 and 24:1 (p=0.01). The mean synovial fluid Co/Cr concentrations were elevated in patients with ALTR compared to those without (2,007.3 vs. 12.4 ppb, P=0.007), and (3,188.2 vs. 10.3 ppb, P=0.02). The synovial fluid Co concentration was the most accurate test for detecting ALTR (Cut off: 19.75 PPB, AUC 0.973). In patients with ALTR, synovial fluid Co and Cr levels were 120 times higher and 414 times higher than whole blood Co and Cr levels. Synovial fluid Co ion concentration was the most accurate in predicting ALTR.
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影响因子：
4.6
作者：
Sidaginamale, R. P.;Joyce, T. J.;Langton, D. J.
通讯作者：
Langton, D. J.
影响因子：
3.7
作者：
Durrani SK;Noble PC;Sampson B;Panetta T;Liddle AD;Sabah SA;Chan NK;Skinner JA;Hart AJ
通讯作者：
Hart AJ
影响因子：
3.5
作者：
Nodzo, Scott R.;Esposito, Christina I.;Padgett, Douglas E.
通讯作者：
Padgett, Douglas E.
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：
3.5
作者：
Griffin, William L.;Fehring, Thomas K.;Dennos, Anne C.
通讯作者：
Dennos, Anne C.