Inova Center for Joint Replacement, Mount Vernon Hospital, Alexandria, VA, USA.
J Arthroplasty. 2012 Sep;27(8 Suppl):26-31.e1. doi: 10.1016/j.arth.2012.03.019. Epub 2012 May 2.
We evaluated taper corrosion in 36-mm diameter metal-on-metal (MOM) and metal-on-polyethylene (MOP) femoral heads from a single manufacturer retrieved for various reasons. Three reviewers visually graded taper corrosion with a 5-point scale on 19 MOM heads and 14 MOP heads. The MOM group had a higher corrosion score than the MOP group (mean, 3.5 vs 1.9; P < .001). There were 8 MOM heads (42%) and only 1 MOP head (7%) that demonstrated corrosion outside of the taper zone. Metal-on-metal patients revised secondary to adverse local tissue reactions (ALTRs) had greater scores than patients without ALTRs (mean, 4.36 vs 2.38; P < .01). Adverse local tissue reactions MOM patients were also likely to have corrosion outside of the taper junction. The corrosion score increased with implantation time, and at all time intervals, the corrosion score for the MOM group was greater. Because corrosion worsens with time, we are concerned that MOM ALTR failures will increase with longer follow-up.
我们评估了因各种原因而取出的来自单一制造商的 36 毫米直径金属对金属(MOM)和金属对聚乙烯(MOP)股骨头的锥形腐蚀。三位评审员使用 5 分制对 19 个 MOM 头和 14 个 MOP 头的锥形腐蚀进行了视觉分级。MOM 组的腐蚀评分高于 MOP 组(平均 3.5 对 1.9;P<.001)。有 8 个 MOM 头(42%)和仅 1 个 MOP 头(7%)显示出锥形区外的腐蚀。由于不良局部组织反应(ALTR)而翻修的 MOM 患者的评分高于无 ALTR 的患者(平均 4.36 对 2.38;P<.01)。MOM 患者的 ALTR 也可能在锥形交界处外发生腐蚀。腐蚀评分随植入时间增加而增加,在所有时间间隔内,MOM 组的腐蚀评分都更高。由于腐蚀随时间恶化,我们担心随着随访时间的延长,MOM ALTR 故障的发生率将会增加。