Scaglione M, Fabbri L, Bianchi N, Dell'Omo D, Guido G
Department of Orthopedics, University of Pisa, Via Paradisa 2, Ed 3, 56100, Pisa, Italy,
Musculoskelet Surg. 2015 Apr;99(1):45-53. doi: 10.1007/s12306-014-0344-x. Epub 2014 Dec 24.
We report the clinical, radiological and wear analysis of 52 consecutive MoM hip resurfacings (performed on 49 younger patients) to a mean follow-up of 9.2 years.
Every patient underwent X-ray and clinical evaluation (HHS). Ultrasonography of the hip was performed in all patients in order to identify possible cystic or solid mass in periprosthetic tissue. In case of mass >20 mm, further MRI was performed to better analyse the characteristics of lesion.
Five patients (five hips) had a revision. The overall survival rate was 90.38 %. The average HHS at follow-up examination was 95.5 points. No progressive radiolucent areas and no sclerosis or osteolysis around the implants were found. The US and RMI imaging showed a pseudotumour formation in two patients (correlated with high metal ion levels in blood and urine), both asymptomatic.
A significant positive correlation between inclination of the acetabular component and serum metal ion levels was found (r = 0.64 and r = 0.62 for cobalt and chromium, respectively).
我们报告了连续52例金属对金属髋关节表面置换术（对49例年轻患者实施）的临床、影像学及磨损分析，平均随访9.2年。
每位患者均接受X线和临床评估（Harris髋关节评分）。对所有患者进行髋关节超声检查，以确定假体周围组织中是否存在可能的囊性或实性肿块。若肿块直径>20 mm，则进一步行MRI检查以更好地分析病变特征。
5例患者（5髋）进行了翻修手术。总体生存率为90.38%。随访检查时的平均Harris髋关节评分为95.5分。未发现假体周围有进行性透亮区，也未发现植入物周围有硬化或骨溶解。超声和MRI成像显示2例患者有假瘤形成（与血液和尿液中高金属离子水平相关），二者均无症状。
发现髋臼假体倾斜度与血清金属离子水平之间存在显著正相关（钴和铬的相关系数分别为r = 0.64和r = 0.62）。
