Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.
Int Orthop. 2012 Mar;36(3):539-44. doi: 10.1007/s00264-011-1317-4. Epub 2011 Jul 14.
The effects of systemic metal ion exposure in patients with implants made of common prosthetic alloys continue to be a matter of concern. The aim of the study was to determine the measurement values of cobalt (Co), chromium (Cr) and molybdenum (Mo) in serum following rotating-hinge knee arthroplasty.
Blood was taken from 25 patients [mean follow-up 35 (range nine to 67) months] treated with megaprostheses (n=17) or standard rotating-hinge devices (n=8) and analysed using electrothermal graphite furnace atomic absorption spectrometry (ET-ASS).
Determining the concentrations of metal ions following rotating-hinge knee arthroplasty revealed increments for Co and Cr but not Mo. Metal ion release was significantly higher in patients with megaprostheses compared to a standard rotating-hinge knee device (Co p=0,024; Cr p=0.025).
The authors believe there might be an additional metal ion release from the surface of the prosthesis and not only from the articulating surfaces because, in cases of rotating-hinge knee prosthesis, there is a metal-on-polyethylene articulation and not a direct metal-on-metal junction. Nevertheless, long-term studies are required to determine adverse effects of Co, Cr and Mo following total hip replacement and total knee arthroplasty.
植入常用假体合金的患者体内的系统性金属离子暴露的影响仍然是一个令人关注的问题。本研究的目的是确定旋转铰链膝关节置换术后血清中钴（Co）、铬（Cr）和钼（Mo）的测量值。
采集了 25 名患者（平均随访 35 个月[9 至 67 个月]）的血液，这些患者接受了 megaprostheses（n=17）或标准旋转铰链装置（n=8）治疗，并使用电热石墨炉原子吸收光谱法（ET-ASS）进行分析。
旋转铰链膝关节置换术后金属离子浓度的测定显示 Co 和 Cr 增加，但 Mo 没有增加。与标准旋转铰链膝关节装置相比，megaprostheses 患者的金属离子释放明显更高（Co p=0.024；Cr p=0.025）。
作者认为可能有来自假体表面的额外金属离子释放，而不仅仅来自关节表面，因为在旋转铰链膝关节假体中，存在金属对聚乙烯关节，而不是直接的金属对金属连接。然而，需要进行长期研究以确定髋关节置换和膝关节置换后 Co、Cr 和 Mo 的不良影响。
