SYSTEMIC IMPLICATIONS OF TOTAL JOINT REPLACEMENT

目前全关节置换术（TJR）的临床趋势包括 在年轻患者中植入和使用非骨水泥， 多孔涂覆的金属部件，其释放更大量的 腐蚀产物 体外和体内（动物和人） 研究表明，广泛的可能的局部和系统性 TJR释放金属的生物学后遗症。 拟议 研究将解决一个重要的前兆，以了解 这些效应的临床意义： 患者体内金属部分的释放、转运和储存 全髋关节置换术（THR）。 该提案涉及三个 这些研究将侧重于不同的患者群体。 第一 本研究是对金属离子释放的前瞻性纵向研究 在接受初次THR的患者中， 钛基合金假体，一种非骨水泥型钴基合金 假体或骨水泥型钴基合金假体。 第二 研究将检查金属离子释放和局部金属离子 无菌性THR翻修患者中的累积 骨水泥型和非骨水泥型钛基合金松动， 钴基合金假体 第三项研究将审查 身体金属库存在已故的个人与水泥和 非骨水泥钛基合金或钴基合金THR。 的 主要分析方法是塞曼原子吸收法 分光光度法（ZAAS）。 这些研究的结果将是至关重要的评估 使用新兴全关节置换术对患者的预期风险 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.