Oshima Yasushi, Fetto Joseph F
Division of Adult Reconstructive Surgery, Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, 530 First Avenue, Suite 5G, New York, NY, 10016, USA,
J Mater Sci Mater Med. 2015 Jan;26(1):5383. doi: 10.1007/s10856-015-5383-9. Epub 2015 Jan 20.
Metal-on-metal had been proposed as an optimal articulation in THRs, however, many monoblock prostheses have been recalled in the USA because of significant high rates of early failure. Metal-on-metal prostheses had been implanted in our institution, and this is a case history of a single patient, in whom metal-on-metal THRs with different femoral sizes of heads were implanted. A 57-year-old female patient underwent bilateral total hip replacements with metal-on-metal prostheses using metal-polyethylene "sandwich" liners 9 years ago on the right side and 7 years ago on the left side respectively. The only difference in both sides was the femoral head diameter of 28 mm in right and 34 mm in left. Seven years after the left surgery, the acetabular liner was dissociated, however, metallosis was not detected. Although the larger femoral head was thought to increase hip joint stability, it dictated a reduction in polyethylene thickness in this prosthesis design, and it was 4 mm in the left hip. Recently, metal-on-metal articulations are thought not to be optimal for hip joint bearing surface, however, this clinical failure was due to the polyethylene thickness and quality.
金属对金属曾被提议作为全髋关节置换术（THRs）中的一种理想关节连接方式，然而，在美国许多一体式假体已因早期失败率极高而被召回。我们机构曾植入过金属对金属假体，这是一位单一患者的病例史，该患者植入了不同股骨头尺寸的金属对金属全髋关节置换假体。一名57岁女性患者分别于9年前在右侧和7年前在左侧接受了使用金属 - 聚乙烯“三明治”衬垫的双侧金属对金属全髋关节置换术。两侧唯一的区别在于右侧股骨头直径为28毫米，左侧为34毫米。左侧手术7年后，髋臼衬垫发生分离，然而，未检测到金属沉着病。尽管较大的股骨头被认为可增加髋关节稳定性，但在这种假体设计中它要求减小聚乙烯厚度，左侧髋关节的聚乙烯厚度为4毫米。近来，金属对金属关节连接方式被认为并非髋关节承重面的理想选择，然而，此次临床失败是由于聚乙烯的厚度和质量问题。
