SYSTEMIC IMPLICATIONS OF TOTAL JOINT REPLACEMENT

目前全关节置换(TJR)的临床趋势包括 在较年轻的患者中植入和使用非骨水泥， 多孔涂层金属部件，释放出更多的 腐蚀产物。体外和活体(动物和人) 研究表明，可能存在广泛的局部和系统性 TJRs释放金属的生物后遗症。建议数 研究将解决了解 这种效应的临床意义：对 慢性阻塞性肺疾病患者体内金属部分的释放转运和储存 全髋关节置换(THR)。这项提案涉及三个方面 将专注于不同患者群体的研究。第一 这是一项前瞻性的、纵向的金属离子释放研究。 在接受直接THR手术的患者中， 钛基合金假体--一种无水泥钴基合金 假体或粘结的钴基合金假体。第二 研究将检查金属离子释放和局部金属离子 无菌翻修THR患者体内的蓄积 粘结和非粘结钛基合金的松动 钴基合金假体。第三项研究将检查总 骨水泥型和骨水泥型已故个体的体内金属库存 无水泥钛基合金或钴基合金THR。这个 主要分析费用是塞曼原子吸收 分光光度法(ZAAS)。 这些研究的结果将是评估的关键 新型全关节置换术对患者的前瞻性风险 替代技术。

Current clinical trends in total joint replacement (TJR) include implantation in younger patients and the use of non-cemented, porous coated metallic components which release greater amounts of corrosion products. In vitro and in vivo (animal and human) studies suggest a wide range of possible local and systemic biological sequelae to metallic release by TJRs. The proposed studies will address an important precursor to understanding the clinical significance of such effects: characterization of the release transport an storage of metallic moieties in patients with total hip replacements (THRs). This proposal involves three studies that will focus on distinct patient populations. The first study is a prospective, longitudinal study of metal ion release in patients undergoing primary THR with either a cementless titanium-base alloy prosthesis, a cementless cobalt-base alloy prosthesis or a cemented cobalt-base alloy prosthesis. The second study will examine metal ion release and local metal ion accumulation in patients undergoing revision THR for aseptic loosening of both cemented and cementless titanium-base alloy and cobalt-base alloy prosthesis. The third study will examine total body metal inventories in deceased individuals with cemented and cementless titanium-base alloy or cobalt-base alloy THRs. The primary analytical toll is Zeeman atomic absorption spectrophotometry (ZAAS). The results of theses studies will be critical in evaluating prospective risk to patients of the use of emerging total joint replacement technologies.