Department of Orthopaedic Surgery, Medical University of Graz, Graz, Austria.
BMC Musculoskelet Disord. 2012 Apr 11;13:56. doi: 10.1186/1471-2474-13-56.
Metal-on-metal hip resurfacing is an alternative to metal-on-metal total hip arthroplasty, especially for young and physically active patients. However, wear which might be detected by increased serum ion levels is a matter of concern.
The aims of this preliminary study were to determine the raise of metal ion levels at 2-years follow-up in a prospective setting and to evaluate differences between patients with either resurfacing or total hip arthroplasty. Furthermore we investigated if the inclination of the acetabular component and the arc of cover would influence these findings. Therefore, 36 patients were followed prospectively.
The results showed increments for Co and Cr in both implant groups. Patients treated with large-diameter total hip arthroplasty showed fourfold and threefold, respectively, higher levels for Co and Cr compared to the resurfacing group (Co: p < 0,001 and Cr: p = 0,005). Nevertheless, we observed no significant correlation between serum ion levels, inclination and arc of cover.
In order to clarify the biologic effects of ion dissemination and to identify risks concerning long-term toxicity of metals, the exposure should be monitored carefully. Therefore, long-term studies have to be done to determine adverse effects of Co and Cr following metal-on-metal hip replacement.
金属对金属髋关节表面置换术是金属对金属全髋关节置换术的一种替代方法，尤其适用于年轻且活跃的患者。然而，人们对因磨损导致血清离子水平升高而产生的副作用感到担忧。
本初步前瞻性研究旨在确定金属离子水平在 2 年随访时的升高情况，并评估髋关节表面置换术与全髋关节置换术患者之间的差异。此外，我们还研究了髋臼组件的倾斜度和覆盖弧是否会影响这些发现。因此，36 例患者接受了前瞻性随访。
结果显示，两组患者的 Co 和 Cr 均有升高。与髋关节表面置换组相比，接受大直径全髋关节置换术的患者的 Co 和 Cr 水平分别高出四倍和三倍（Co：p<0.001，Cr：p=0.005）。然而，我们并未观察到血清离子水平、倾斜度和覆盖弧之间存在显著相关性。
为了阐明离子释放的生物学效应，并确定金属长期毒性的风险，应密切监测暴露情况。因此，需要进行长期研究以确定金属对金属髋关节置换术后 Co 和 Cr 的不良影响。
