Clough E J, Clough T M
University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
Wrightington Hospital, Hall Lane, Wigan, WN6 9EP, UK.
J Orthop. 2020 Dec 31;23:123-127. doi: 10.1016/j.jor.2020.12.036. eCollection 2021 Jan-Feb.
Metal on metal hip resurfacing arthroplasty (HRA) was introduced in an attempt to address potential limitations regarding return to sport, return to high functional activity and premature wear in young patients requiring standard total hip replacement (THR). Around 12% patients undergoing hip replacement surgery are under 55 years of age. By more closely mimicking natural anatomy, and having a metal on metal (MoM) bearing, it was hoped that HRA would address the issues. However, concern has emerged about early failure, high revision rates from local adverse reactions to metallic wear debris and potential systemic consequences of metal ion cardiotoxicity. In this article, we discuss the existing literature in the field, the current clinical evidence surrounding HRA, its indications, clinical outcomes, and risk factors for failure and conclude if it still has a role within orthopaedic hip surgery.
金属对金属髋关节表面置换术（HRA）被引入，旨在解决年轻患者在进行标准全髋关节置换术（THR）时，在恢复运动、恢复高功能活动以及过早磨损方面可能存在的局限性。大约12%接受髋关节置换手术的患者年龄在55岁以下。人们希望通过更紧密地模仿自然解剖结构，并采用金属对金属（MoM）轴承，HRA能够解决这些问题。然而，人们已经开始关注早期失败、因对金属磨损碎片的局部不良反应导致的高翻修率以及金属离子心脏毒性的潜在全身后果。在本文中，我们讨论了该领域的现有文献、围绕HRA的当前临床证据、其适应症、临床结果以及失败的风险因素，并得出结论，即它在骨科髋关节手术中是否仍有作用。
