Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
Medicina (Kaunas). 2021 Jan 28;57(2):115. doi: 10.3390/medicina57020115.
The present research evaluated the course of cobalt and chromium in the blood and urine after the revision of metal-on-metal with a ceramic-on-polyethylene total hip arthroplasty. Seven patients were enrolled for hip prosthesis revision owing to ascertained damage of the implant. Metals in the blood and urine were evaluated before and after the hip revision. The double measurement before the total hip revision revealed high levels of metal ions (on average, 88.1 µg/L of cobalt in the blood, 399.0 µg/g of creatinine cobalt in the urine, 46.8 µg/L of chromium in the blood, and 129.6 µg/g of creatinine chromium in the urine at the first measurements), with an increasing trend between the first and second dosage. Within a week after the hip revision, the levels of metal ions significantly decreased by approximately half. Four to six months after the operation, the cobalt levels were found near to the reference values, whereas the chromium levels reached 25% of the values measured before the revision. The revision of malfunctioning metal-on-metal implants produced a dramatic decrease of metal ions in biological fluids, although it did not completely rescue the chromium level.
本研究评估了陶瓷对聚乙烯全髋关节置换术后修订金属对金属假体后血液和尿液中钴和铬的变化。由于确定了植入物的损坏，有 7 名患者接受了髋关节假体翻修。在髋关节翻修前后评估了血液和尿液中的金属。全髋关节翻修前的两次测量显示金属离子水平较高（平均血液中钴为 88.1µg/L，尿液中肌酐钴为 399.0µg/g，血液中铬为 46.8µg/L，尿液中肌酐铬为 129.6µg/g，第一次测量），两次测量之间呈上升趋势。髋关节翻修后一周内，金属离子水平显著下降约一半。术后 4 至 6 个月，钴水平接近参考值，而铬水平达到翻修前测量值的 25%。有故障的金属对金属植入物的翻修导致生物液中的金属离子显著减少，尽管它并没有完全恢复铬水平。
