Dahlstrand Henrik, Stark André, Anissian Lucas, Hailer Nils P
Department of Molecular Medicine and Surgery, Section of Orthopaedics, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
J Arthroplasty. 2009 Sep;24(6):837-45. doi: 10.1016/j.arth.2008.07.019. Epub 2008 Sep 26.
In this prospective randomized study, we investigate metal ion concentrations and clinical outcome 2 years after metal-on-metal (28 patients) or metal-on-polyethylene (26 patients) hip arthroplasty with 28-mm modular heads. Metal ion concentrations in patient serum were analyzed by high-resolution plasma mass spectrometry. The clinical outcome was almost identical in both groups with respect to the Harris hip score and the Medical Outcome Study Short Form-36; and on plain radiography, no signs of loosening occurred in any group. In the metal-on-metal group, concentrations of all investigated ions increased significantly when compared with preoperative values: cobalt, 15.3-fold (95% confidence interval [CI], 9.4-21.2); chromium, 5.2-fold (CI, 3.5-7.0); nickel, 2.1-fold (CI, 1.2-3.0); and manganese, 1.6-fold (CI, 1.3-2.0). In the metal-on-polyethylene group, a smaller but significant increase in the concentrations of cobalt and nickel occurred, whereas concentrations of the other ions did not change significantly.
在这项前瞻性随机研究中，我们调查了采用28毫米组合式股骨头的金属对金属（28例患者）或金属对聚乙烯（26例患者）髋关节置换术后2年的金属离子浓度和临床结果。通过高分辨率等离子体质谱分析患者血清中的金属离子浓度。在Harris髋关节评分和医学结局研究简表36方面，两组的临床结果几乎相同；在X线平片上，任何一组均未出现松动迹象。在金属对金属组中，与术前值相比，所有研究离子的浓度均显著增加：钴增加15.3倍（95%置信区间[CI]，9.4 - 21.2）；铬增加5.2倍（CI，3.5 - 7.0）；镍增加2.1倍（CI，1.2 - 3.0）；锰增加1.6倍（CI，1.3 - 2.0）。在金属对聚乙烯组中，钴和镍的浓度有较小但显著的增加，而其他离子的浓度没有显著变化。
