Sumiyoshi Nobuhiko, Oinuma Kazuhiro, Miura Yoko
Funabashi Orhopaedic Hospital, Funabashi, Chiba, Japan.
SAGE Open Med. 2021 May 16;9:20503121211014707. doi: 10.1177/20503121211014707. eCollection 2021.
Adverse reactions to metal debris are significant complications after metal-on-metal total hip arthroplasty. Recently, late appearances of adverse reactions to metal debris and subsequent need for reoperations have been reported with small-diameter head metal-on-metal devices. We retrospectively investigated mid-term clinical outcomes of small-head metal-on-metal total hip arthroplasty.
We reviewed 159 hips in 139 patients who had a small-head metal-on-metal total hip arthroplasty (M2a Taper; Biomet, Warsaw, IN) with a minimum 5-year follow-up and documented postoperative complications.
Focal osteolysis in either the femur or acetabulum was observed in 12 hips (7.5%, 44 months after surgery on average), with pseudotumor observed in 8 hips (5%, 120 months after surgery on average). Four hips (2.5%) had dislocations (84 months after surgery on average) and six hips (3.8%, 122 months after surgery on average) underwent reoperation.
Small-head metal-on-metal total hip arthroplasty is associated with a high degree of complications at mid-term follow-up period. Considering this, we discourage the use of metal-on-metal total hip arthroplasty regardless of head size.
金属对金属全髋关节置换术后金属碎屑引起的不良反应是严重的并发症。最近，有报道称小直径股骨头金属对金属装置会出现金属碎屑不良反应的晚期表现以及随后需要再次手术的情况。我们回顾性研究了小头金属对金属全髋关节置换术的中期临床结果。
我们回顾了139例患者的159髋，这些患者接受了小头金属对金属全髋关节置换术（M2a锥度；Biomet，华沙，印第安纳州），并进行了至少5年的随访且记录了术后并发症。
12髋（7.5%，平均术后44个月）在股骨或髋臼出现局灶性骨溶解，8髋（5%，平均术后120个月）出现假肿瘤。4髋（2.5%）发生脱位（平均术后84个月），6髋（3.8%，平均术后122个月）接受了再次手术。
在中期随访期，小头金属对金属全髋关节置换术有高度的并发症。考虑到这一点，无论股骨头大小，我们都不鼓励使用金属对金属全髋关节置换术。
