Hernandez-Vaquero D, Rodríguez de la Flor M, Fernandez-Carreira J M, Sariego-Muñiz C
Servicio de Cirugía Ortopédica y Traumatología, Hospital San Agustín, Avilés, Departamento de Cirugía, Facultad de Medicina, Universidad de Oviedo, España.
Servicio de Farmacia Hospitalaria, Hospital San Agustín, Avilés, España.
Rev Esp Cir Ortop Traumatol. 2014 Sep-Oct;58(5):267-73. doi: 10.1016/j.recot.2014.01.008. Epub 2014 Mar 11.
There is an increase in the levels of metals in the serum and urine after the implantation of some models of metal-metal hip prosthesis. It has recently been demonstrated that there is an association between these levels and the levels found in hair. The aim of this study is to determine the presence of metals in hair, and to find out whether these change over time or with the removal of the implant.
The levels of chromium, cobalt and molybdenum were determined in the hair of 45 patients at 3, 4, 5, and 6 years after a hip surface replacement. The mean age was 57.5 years, and two were female. Further surgery was required to remove the replacement and implant a new model with metal-polyethylene friction in 11 patients, 5 of them due to metallosis and a periarticular cyst.
The mean levels of metals in hair were chromium 163.27 ppm, cobalt 61.98 ppm, and molybdenum 31.36 ppm, much higher than the levels found in the general population. A decrease in the levels of chromium (43.8%), molybdenum (51.1%), and cobalt (91.1%) was observed at one year in the patients who had further surgery to remove the prosthesis.
High concentrations of metals in the hair are observed in hip replacements with metal-metal friction, which decrease when that implant is removed. The determination of metal ions in hair could be a good marker of the metal poisoning that occurs in these arthroplasty models.
植入某些型号的金属对金属髋关节假体后，血清和尿液中的金属水平会升高。最近已证明这些水平与头发中发现的水平之间存在关联。本研究的目的是确定头发中金属的存在情况，并查明这些金属含量是否会随时间变化或随着植入物的取出而改变。
对45例患者在髋关节表面置换术后3年、4年、5年和6年时头发中的铬、钴和钼水平进行了测定。平均年龄为57.5岁，其中两名女性。11例患者需要进一步手术取出置换物并植入具有金属-聚乙烯摩擦界面的新型假体，其中5例是由于金属中毒和关节周围囊肿。
头发中金属的平均水平为铬163.27 ppm、钴61.98 ppm和钼31.36 ppm，远高于普通人群中的水平。在接受进一步手术取出假体的患者中，观察到铬（43.8%）、钼（51.1%）和钴（91.1%）的水平在一年时有所下降。
在具有金属对金属摩擦界面的髋关节置换术中，头发中观察到高浓度的金属，当取出该植入物时金属浓度会降低。测定头发中的金属离子可能是这些关节成形术模型中发生金属中毒的良好标志物。
