Kuzyk Paul R T, Sellan Michael, Olsen Michael, Schemitsch Emil H
Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Bull NYU Hosp Jt Dis. 2011;69 Suppl 1:S5-11.
A systematic review and meta-analysis of trials comparing hip resurfacing to metal-on-metal total hip arthroplasty was conducted to determine if there is a difference in serum metal ion levels in patients receiving these implants. EMBASE and MEDLINE databases were searched from inception to December 2010 for all trials involving the use of these devices. Eligibility for inclusion in the review were studies with 1. comparative trials that were both retrospective and prospective; 2. inclusion of a treatment arm receiving hip resurfacing; 3. inclusion of a treatment arm receiving metal-on-metal total hip arthroplasty; and 4. analysis of chromium and cobalt ions, or either, in patient serum or whole blood at a minimum of 1 year after implantation. The literature search identified 87 potential studies, of which 10 met the inclusion criteria. Pooled mean differences were calculated for serum cobalt and chromium ion levels. Mean differences for serum cobalt and chromium metal ions were not significantly different between hip resurfacing and metal-on-metal total hip arthroplasty patients, although there was a tendency for lower serum cobalt ion levels in patients receiving hip resurfacing. Larger prospective randomized trials are required to better substantiate a difference in metal ion levels occurring between these implants.
开展了一项系统评价和荟萃分析，比较髋关节表面置换术与金属对金属全髋关节置换术，以确定接受这些植入物的患者血清金属离子水平是否存在差异。检索了EMBASE和MEDLINE数据库，涵盖从建库至2010年12月所有涉及使用这些器械的试验。纳入该评价的标准为：1. 包括回顾性和前瞻性研究的对照试验；2. 纳入接受髋关节表面置换术的治疗组；3. 纳入接受金属对金属全髋关节置换术的治疗组；4. 在植入后至少1年分析患者血清或全血中的铬和钴离子，或其中之一。文献检索确定了87项潜在研究，其中10项符合纳入标准。计算了血清钴和铬离子水平的合并平均差异。髋关节表面置换术患者与金属对金属全髋关节置换术患者血清钴和铬金属离子的平均差异无显著差异，不过接受髋关节表面置换术的患者血清钴离子水平有降低趋势。需要开展更大规模的前瞻性随机试验，以更好地证实这些植入物之间金属离子水平的差异。
