Hernández-Vaquero D, García-Pascual M, Iglesias-Fernández S, Escandon-Rodríguez A
Departamento de Cirugía, Facultad de Medicina, Universidad de Oviedo, Oviedo, España; Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario San Agustín, Avilés, España.
Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario San Agustín, Avilés, España.
Rev Esp Cir Ortop Traumatol (Engl Ed). 2018 Nov-Dec;62(6):436-441. doi: 10.1016/j.recot.2018.03.001. Epub 2018 Jun 6.
Blood cobalt (Co) and chromium (Cr) ion levels have been used as surveillance tools for adverse reaction to metal debris in metal-on-metal (MoM) hip arthroplasty. The aim of our study was to present serial 7-13 year blood Co and Cr levels in a cohort of MoM total hip arthroplasties in asymptomatic patients.
A total of 52 MoM surface total hip arthroplasties were included in this study with data collected prospectively. Annual follow-up with blood Co and Cr measurements was performed. Revision surgery was necessary for 16 patients and therefore they dropped out of the study. The metal ion levels were analyzed separately in 31 asymptomatic patients.
High Cr or Co levels were not found continuously in any of the asymptomatic patients. The median Cr in blood was maintained between 1.3 and 5.4μg/L and that of Co between 0.5 and 1.2μg/L. After 7 years, there was no significant change in Co and Cr values.
In the medium term and in asymptomatic patients, the metallic blood levels remained unchanged; therefore, it does not seem appropriate to repeat these tests on a permanent basis in annual controls.
血液中钴（Co）和铬（Cr）离子水平已被用作监测金属对金属（MoM）髋关节置换术中金属碎屑不良反应的工具。我们研究的目的是呈现一组无症状患者的MoM全髋关节置换术后7至13年的连续血液Co和Cr水平。
本研究共纳入52例MoM表面全髋关节置换术，前瞻性收集数据。每年进行随访并测量血液Co和Cr。16例患者需要翻修手术，因此退出研究。对31例无症状患者的金属离子水平进行了单独分析。
在任何无症状患者中均未持续发现高Cr或Co水平。血液中Cr的中位数维持在1.3至5.4μg/L之间，Co的中位数维持在0.5至1.2μg/L之间。7年后，Co和Cr值无显著变化。
在中期和无症状患者中，血液中的金属水平保持不变；因此，在年度检查中定期重复这些检测似乎并不合适。
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