Orthopaedic and Traumatology Department, Santo Stefano Hospital, Azienda USL Toscana Centro, Prato, Italy.
Int Orthop. 2019 Jan;43(1):97-101. doi: 10.1007/s00264-018-4128-z. Epub 2018 Sep 7.
The aim of this study is to present an algorithm for the evaluation of both symptomatic and asymptomatic patients.
From November 2004 to May 2010, there were performed 296 operations: 245 total hip arthroplasty and 51 resurfacing arthroplasty with the ASR DePuy system. In April 2010, there was the first Medical Device Alert regarding all MoM hip replacements in the UK and in August 2010, DePuy recall started worldwide. In March 2012, we started our recall. All patients were invited to undergo clinical investigation, X-ray evaluations, and blood chrome and cobalt level determination. For a short period of time, there were performed second level exams and subsequently, we carried out MARS MRI hip study to all symptomatic patients and there was evidence of ALVAL lesions.
To the patients with ALVAL lesions were proposed surgical hip revision while the others frequent follow-up controls. One hundred patients underwent hip surgical revision.
We recommend constant MoM THA patients monitoring and early revision if necessary.
本研究旨在提出一种针对有症状和无症状患者的评估算法。
2004 年 11 月至 2010 年 5 月，共进行了 296 例手术：245 例全髋关节置换术和 51 例 ASR DePuy 系统表面置换术。2010 年 4 月，英国首次发布了所有 MoM 髋关节置换物的医疗器械警报，2010 年 8 月，DePuy 开始在全球范围内召回。2012 年 3 月，我们开始召回。所有患者均被邀请接受临床检查、X 射线评估以及血液铬和钴水平测定。在短时间内，我们进行了二级检查，随后对所有有症状的患者进行了 MARS MRI 髋关节研究，并发现了 ALVAL 病变。
对有 ALVAL 病变的患者建议进行髋关节手术翻修，而其他患者则进行定期随访。有 100 名患者接受了髋关节手术翻修。
我们建议对 MoM THA 患者进行持续监测，并在必要时尽早进行翻修。
