全髋关节置换术中不兼容金属对金属关节的大量磨损。

Massive wear of an incompatible metal-on-metal articulation in total hip arthroplasty.

作者信息

Keel Johannes B, Kuster Markus S

机构信息

Department of Orthopaedic Surgery, Kantonsspital St. Gallen, Switzerland.

出版信息

J Arthroplasty. 2004 Aug;19(5):638-42. doi: 10.1016/j.arth.2003.12.076.

DOI:10.1016/j.arth.2003.12.076

PMID:15284987

Abstract

We report on a case of massive wear because of an incompatible metal-on-metal combination. In a 62-year-old man, a cobalt-chromium (CoCr) inlay and a stainless steel head were paired by accident. Because of persistent pain, revision surgery was performed 7 months later. Histologic analysis of the surrounding tissue revealed massive metallosis. The wear volume was increased by a factor of 18 for the head and 2 for the cup compared with normal metal-on-metal articulation. The serum concentrations of chromium and cobalt were increased by a factor of 20 and 4 over levels of a healthy population, respectively. Incompatible metal-on-metal combinations should be revised immediately. In case of delayed diagnosis, no metal-on-metal articulation should be implanted because of the high volume of metal in the human body.

摘要

我们报告了一例因金属对金属组合不兼容导致大量磨损的病例。在一名62岁男性中，钴铬（CoCr）嵌体与不锈钢股骨头意外配对。由于持续疼痛，7个月后进行了翻修手术。对周围组织的组织学分析显示有大量金属沉着病。与正常金属对金属关节相比，股骨头的磨损量增加了18倍，髋臼杯的磨损量增加了2倍。血清铬和钴浓度分别比健康人群水平高出20倍和4倍。不兼容的金属对金属组合应立即翻修。如果诊断延迟，由于人体中金属含量高，不应植入金属对金属关节。