Iqbal Hafiz J, Al-Azzani Waheeb A K, Jackson-Taylor Esther, Clatworthy Elizabeth, John Alun
University Hospital of Wales, Cardiff - UK.
Hip Int. 2017 May 12;27(3):235-240. doi: 10.5301/hipint.5000460. Epub 2017 Feb 3.
We aimed to assess the early outcome following revision arthroplasty for failed metal-on-metal (MoM) total hip replacements (THR) due to adverse reaction to metal debris (ARMD).
We reviewed 106 consecutive revision arthroplasties. Case notes and radiological investigations were reviewed to assess the complications. Oxford Hip Score (OHS) and Euroqol (EQ-5D-3L) scores were used to assess the functional outcome and improvement of quality of life.
At a mean follow-up of 20 months (12-48 months), the mean OHS was 28.7. Pain improved in 61% patients. A majority of patients were in level 2 for all the EQ-5D-3L dimensions. The overall complication rate was 16%. Survivorship free from further revision for any cause was 94.3% at 48 months. There was no correlation between pre-revision blood metal ions and the final outcome.
Revision surgery for failed MoM hip replacement due to ARMD is associated with a relatively higher rate of complications and risk of chronic pain. There is poor correlation between serum metal ions and development of ARMD and outcome following revision surgery.
我们旨在评估因金属碎屑不良反应（ARMD）导致金属对金属（MoM）全髋关节置换术（THR）失败后翻修关节成形术的早期疗效。
我们回顾了106例连续的翻修关节成形术。回顾病例记录和影像学检查以评估并发症。使用牛津髋关节评分（OHS）和欧洲五维度健康量表（EQ-5D-3L）评分来评估功能结局和生活质量改善情况。
平均随访20个月（12 - 48个月）时，平均OHS为28.7。61%的患者疼痛得到改善。大多数患者在EQ-5D-3L所有维度上处于2级。总体并发症发生率为16%。48个月时因任何原因无需进一步翻修的生存率为94.3%。翻修术前血液金属离子与最终结局之间无相关性。
因ARMD导致MoM髋关节置换失败后的翻修手术与相对较高的并发症发生率和慢性疼痛风险相关。血清金属离子与ARMD的发生以及翻修手术后的结局之间相关性较差。
