Hôpital Foisor, 35, rue Ferdinand, 021392, Bucarest, Roumanie.
Orthop Traumatol Surg Res. 2010 Feb;96(1):75-9. doi: 10.1016/j.rcot.2009.12.010.
Diagnosis of total hip arthroplasty malfunction is usually based on clinical and radiographic findings, while metal ion blood levels monitoring is generally recommended for metal-on-metal bearings hip replacements. However, these measurements may be very useful in detecting anomalies in other bearing surfaces such as plasma sprayed ceramic bearings. We report on the case of a patient with a painful cementless ceramic-on-ceramic total hip prosthesis (Plasmaceram) for which metal ions blood levels suggested revision surgery in the absence of any demonstrable radiographic anomaly. The high Cobalt and moderate Chromium ion levels in blood suggested a mechanical dysfunction of the bearing couple which revealed to be a severe cam effect requiring revision surgery of both components. Measurement of metal ion blood levels may play a substantial role in the assessment of a total hip prosthesis mechanism when using another bearing surface than metal-on-metal for which this measurement is usually recommended.
全髋关节置换术后故障的诊断通常基于临床和影像学发现，而对于金属对金属关节轴承髋关节置换，通常建议监测金属离子的血液水平。然而，这些测量值对于检测其他轴承表面（如等离子喷涂陶瓷轴承）的异常可能非常有用。我们报告了一例患有疼痛性非骨水泥陶瓷对陶瓷全髋关节假体（Plasmaceram）的患者，该患者的金属离子血液水平表明需要进行翻修手术，尽管没有任何明显的影像学异常。血液中高浓度的钴和中等浓度的铬离子提示轴承对存在机械功能障碍，这被证明是一种严重的凸轮效应，需要对两个部件进行翻修手术。当使用金属对金属以外的其他轴承表面时，金属离子血液水平的测量可能在全髋关节假体机制的评估中发挥重要作用，对于这种测量通常是推荐的。
