钴/铬比例与金属对金属全髋关节置换术中头颈交界处高腐蚀发生率的关系
The Relationship Between Cobalt/Chromium Ratios and the High Prevalence of Head-Stem Junction Corrosion in Metal-on-Metal Total Hip Arthroplasty.
作者信息
Hothi Harry S, Berber Reshid, Whittaker Robert K, Blunn Gordon W, Skinner John A, Hart Alister J
机构信息
Institute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
出版信息
J Arthroplasty. 2016 May;31(5):1123-7. doi: 10.1016/j.arth.2015.11.014. Epub 2015 Nov 26.
BACKGROUND
The size of the clinical impact of corrosion of the taper junction of metal-on-metal total hip arthroplasties (MOM-THAs) is unclear. Examination of a large number of retrieved MOM resurfacings and total hip arthroplasties can help us understand the role of taper corrosion in metal ion release.
METHODS
We graded the severity of corrosion at the taper junction of 395 MOM-THAs and compared the prerevision whole blood metal ion levels of these hips with 529 failed MOM hip resurfacings.
RESULTS
Virtually all MOM-THA hips (n = 388) had evidence of corrosion of the head-stem taper junction and graded as severe in 31% (n = 124). The median cobalt/chromium (Co/Cr) ratio was 1.58 (0.01-13.82) and 1.08 (0-4.86) for MOM-THA and MOM hip resurfacing, respectively; this difference was significant (P < .001). THA hips with severely corroded tapers had the highest median Co/Cr ratio of 1.86 (0.01-10).
CONCLUSIONS
This study demonstrates the high prevalence of severe taper corrosion, which may be related to an elevated Co/Cr ratio before revision.
背景
金属对金属全髋关节置换术（MOM-THA）锥度连接处腐蚀的临床影响程度尚不清楚。检查大量回收的MOM表面置换假体和全髋关节置换假体有助于我们了解锥度腐蚀在金属离子释放中的作用。
方法
我们对395例MOM-THA的锥度连接处腐蚀严重程度进行分级，并将这些髋关节翻修前的全血金属离子水平与529例失败的MOM髋关节表面置换假体进行比较。
结果
几乎所有MOM-THA髋关节（n = 388）都有头-柄锥度连接处腐蚀的证据，其中31%（n = 124）分级为严重腐蚀。MOM-THA和MOM髋关节表面置换假体的钴/铬（Co/Cr）比值中位数分别为1.58（0.01 - 13.82）和1.08（0 - 4.86）；这种差异具有统计学意义（P <.001）。锥度严重腐蚀的THA髋关节的Co/Cr比值中位数最高，为1.86（0.01 - 10）。
结论
本研究表明严重锥度腐蚀的发生率很高，这可能与翻修前Co/Cr比值升高有关。
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