Jemmett P, Parfitt D, Rice R
Acta Orthop Belg. 2016 Sep;82(2):491-196.
The ACCIS hip system has been marketed with a unique bearing surface which the manufacturers claim to reduce wear below the level of other MoM bearings and consequently less metal ion release. The cobalt-chrome-molybdenum alloy is heat treated to reduce the number and size of block carbides and the surface is modified with titanium-niobium-nitride to create a ceramic-like surface. We present our experience with ACCIS. 148 surgical procedures were carried out in 126 patients using the ACCIS hip resurfacing (77) or large head MOM total hip replacement(71). Patients were followed up with regular clinical and radiological assessment. In addition, metal ion levels were obtained. There have been 27 revision procedures carried out for a variety of indications with a current revision rate of 18%. Seven failures could not be attributed to the prosthesis itself, still leaving a failure rate of 13.5%. The mean survival time of these is 33 months, ranging from 1 to 72 months. 13 revisions were -performed for pain and revision demonstrated poor cup integration. 7 were revised because of high ion levels but this was patient choice despite remaining asymptomatic. Whilst the testing phases indicated benefits in wear characteristics, this is not apparent in our group. We have demonstrated an unacceptably high revision rate due to unknown causes and have ceased implanting the ACCIS.
ACCIS髋关节系统在市场上推出时具有独特的承重表面，制造商声称该表面能将磨损降低到低于其他金属对金属轴承的水平，从而减少金属离子释放。钴铬钼合金经过热处理以减少块状碳化物的数量和尺寸，表面用钛铌氮化物进行改性以形成类似陶瓷的表面。我们介绍我们使用ACCIS的经验。对126例患者进行了148次手术，采用ACCIS髋关节表面置换术（77例）或大头金属对金属全髋关节置换术（71例）。对患者进行定期临床和放射学评估随访。此外，还检测了金属离子水平。因各种原因进行了27次翻修手术，目前的翻修率为18%。7例失败不能归因于假体本身，失败率仍为13.5%。这些患者的平均生存时间为33个月，范围为1至72个月。13例因疼痛进行翻修，翻修显示髋臼植入不佳。7例因离子水平高而进行翻修，但这是患者的选择，尽管患者仍无症状。虽然测试阶段显示在磨损特性方面有优势，但在我们的研究组中并不明显。我们已经证明，由于不明原因，翻修率高得令人无法接受，因此已停止植入ACCIS。
