Chang Jun-Dong, Lee Sang-Soo, Hur Mina, Seo Eun-Min, Chung Yung-Khee, Lee Chang-Ju
Department of Orthopaedic Surgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Youngdungpo-gu, Seoul, Republic of Korea.
J Arthroplasty. 2005 Aug;20(5):568-73. doi: 10.1016/j.arth.2005.04.001.
Clinical and radiographic findings of metallosis in relation to the clinical outcome of revision total hip arthroplasty were analyzed for 31 hips. Causes of metallosis were dissociation of polyethylene liner in 24 hips, catastrophic wear in 6, and the screw used for stem fixation in 1. Metallosis was grade I in 12 hips, grade II in 7, and grade III in 12. Osteolysis around the acetabular cup was observed in 24 (77.4%) of 31 hips. At the time of final follow-up evaluation, none of the hips showed osteolysis, acetabular cup migration, or any change in inclination. Although metallosis could not be completely eradicated in severe cases, the clinical outcome for these hips was favorable. This study demonstrates that metallosis frequently causes osteolysis and that complete elimination of it is not a prerequisite for the success of revision total hip arthroplasty.
对31例髋关节翻修术患者的金属沉着病的临床及影像学表现与临床结局进行了分析。金属沉着病的病因包括:24例聚乙烯内衬分离,6例灾难性磨损,1例用于股骨柄固定的螺钉。金属沉着病分级为I级的有12例,II级7例,III级12例。31例患者中有24例(77.4%)髋臼杯周围出现骨溶解。在末次随访评估时,所有髋关节均未出现骨溶解、髋臼杯移位或倾斜度改变。虽然在严重病例中金属沉着病无法完全消除,但这些髋关节的临床结局良好。本研究表明,金属沉着病常导致骨溶解,且完全消除金属沉着病并非髋关节翻修术成功的必要条件。