金属对金属全髋关节置换失败的处理
Management of failed metal-on-metal total hip arthroplasty.
作者信息
Griffin Justin W, D'Apuzzo Michele, Browne James A
机构信息
Justin W Griffin, Michele D'Apuzzo, James A Browne, Department of Orthopaedic Surgery, University of Virginia Health System, 400 Ray C Hunt Dr. Charlottesville, VA 22903, United States.
出版信息
World J Orthop. 2012 Jun 18;3(6):70-4. doi: 10.5312/wjo.v3.i6.70.
Abstract
The theoretical advantages of metal-on-metal (MOM) bearing couples in total hip arthroplasty (THA) have been recently balanced by concerns regarding adverse local and systemic effects. Higher than anticipated early revision rates have been reported by several joint registries. Failed MOM hips present with a spectrum of symptoms and findings and traditional methods of failure must be considered in addition to the failure modes that appear to be unique to the MOM bearing couple. Metal hypersensitivity and soft tissue immune reactions remain incompletely understood and require careful ongoing study. The tools available to evaluate MOM THAs and the indications for revision surgery remain to be defined. Outcomes following revision of MOM hips appear to depend on appropriate evaluation, early identification, and appropriate surgical management.
摘要
金属对金属（MOM）轴承组合在全髋关节置换术（THA）中的理论优势，近来因对局部和全身不良影响的担忧而被抵消。多个关节登记处报告了高于预期的早期翻修率。MOM髋关节置换失败会出现一系列症状和表现，除了MOM轴承组合特有的失败模式外，还必须考虑传统的失败方式。金属超敏反应和软组织免疫反应仍未完全了解，需要持续仔细研究。评估MOM全髋关节置换术的可用工具以及翻修手术的指征仍有待确定。MOM髋关节翻修后的结果似乎取决于适当的评估、早期识别和适当的手术管理。
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