金属对金属全髋关节置换术中MARS MRI检查结果与髋臼位置、金属离子水平及功能的相关性
Correlation of MARS MRI findings with cup position, metal ion levels and function in metal-on-metal total hip arthroplasty.
作者信息
Koutalos Antonios A, Toms Andoni P, Cahir John G, Smith Evert J
机构信息
Avon Orthopaedic Centre, Southmead Hospital, Bristol, UK.
Norfolk and Norwich University Hospital, Norwich, UK.
出版信息
Hip Int. 2020 Jan;30(1):64-70. doi: 10.1177/1120700019868162. Epub 2019 Jul 31.
INTRODUCTION
Metal-on-metal (MoM) total hip arthroplasties (THAs) have been linked with increased incidence of pseudotumours and revision rate. magnetic resonance imaging (MRI) is useful in diagnosing adverse reaction to metal debris (ARMD) disease but it is not known if MRI findings correlate with cup position.
PATIENTS AND METHODS
From a cohort of 79 MoM THA, 34 MRI studies were available. MRI was classified according to Anderson classification. Mean follow-up was 7.1 years. Evaluation included cup position including margin of safety, measurement of metal ion levels and evaluation of function.
RESULTS
44% of patients had definite ARMD. We did not find any correlation between MRI stage and Co, Cr, margin of safety (MOS) or functional scores. However, patients with a margin of safety angle < 21° had more severe findings in MRI.
CONCLUSIONS
Patients with MoM THA experience high degree of ARMD. In our study, the disease did not correlate with metal ion levels but correlated with cup position, evaluated with the MOS angle.
引言
金属对金属（MoM）全髋关节置换术（THA）与假瘤发生率增加和翻修率升高有关。磁共振成像（MRI）有助于诊断金属碎屑不良反应（ARMD）疾病，但尚不清楚MRI表现是否与髋臼位置相关。
患者与方法
在一组79例MoM THA患者中，有34例进行了MRI检查。MRI根据安德森分类法进行分类。平均随访时间为7.1年。评估包括髋臼位置，包括安全边缘、金属离子水平测量和功能评估。
结果
44%的患者患有明确的ARMD。我们未发现MRI分期与钴、铬、安全边缘（MOS）或功能评分之间存在任何相关性。然而，安全边缘角度<21°的患者在MRI上有更严重的表现。
结论
MoM THA患者有高度的ARMD。在我们的研究中，该疾病与金属离子水平无关，但与用MOS角度评估的髋臼位置有关。
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