Augustyn Aleksander, Dobrakowski Michał, Rokicka Dominika, Wróbel Marta, Kasperczyk Sławomir, Strojek Krzysztof, Koczy Bogdan, Stołtny Tomasz
District Hospital of Orthopaedics and Trauma Surgery in Piekary Śląskie, Bytomska St. 62, 41-940 Piekary Śląskie, Poland.
Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Jordana St. 19, 41-808 Zabrze, Poland.
Nanomaterials (Basel). 2025 Aug 15;15(16):1258. doi: 10.3390/nano15161258.
Despite the increasingly rare use of metal-on-metal articulation, in many countries, there is a large group of patients after hip arthroplasty using this method. The operation of the dysfunctional hip joint using metal-on-metal articulation can be performed by resurfacing or total, stemmed arthroplasty. The aim of this study was to compare the metaphyseal and resurfacing methods in metal-on-metal articulation and its impact on clinical status and variability of oxidative stress parameters, as well as the concentration of chromium and cobalt ions in blood. The first group operated using BHR (Smith & Nephew) and Biomet ReCap-Magnum metal-on-metal hip resurfacing implants. The second group operated using Biomet ReCap-Magnum with a Microplasty metaphyseal stem. Two clinical evaluations were conducted in each patient with the use of SF-12, HHS, and WOMAC-hip examination scale systems. The concentrations of metal ions in blood and their impacts on the antioxidant system were also determined twice using various oxidative stress markers. The study included 61 males. The mean values of the Cr ( = 0.019) and Co ( = 0.009) ion concentrations were higher in patients after resurfacing arthroplasty. A higher intensity of oxidative stress (activities of sulphydryl groups, malondialdehyde, and lipofuscin) was observed in the resurfacing group compared with the metaphyseal group. The resurfacing hip implant in the metal-on-metal articulation, to a greater extent than the metaphyseal one, elevates the concentration of Cr and Co ions in the blood and is associated with oxidative stress and the functioning of the antioxidant system.
尽管金属对金属关节置换的使用越来越少，但在许多国家，仍有一大批采用这种方法进行髋关节置换术后的患者。使用金属对金属关节置换的功能障碍髋关节手术可通过表面置换或全髋关节置换术（带柄）来进行。本研究的目的是比较金属对金属关节置换中干骺端和表面置换方法及其对临床状况、氧化应激参数变异性以及血液中铬和钴离子浓度的影响。第一组使用BHR（施乐辉公司）和生物金属ReCap-Magnum金属对金属髋关节表面置换植入物进行手术。第二组使用带有微孔干骺端柄的生物金属ReCap-Magnum进行手术。对每位患者使用SF-12、HHS和WOMAC髋关节检查量表系统进行了两次临床评估。还使用各种氧化应激标志物对血液中金属离子的浓度及其对抗氧化系统的影响进行了两次测定。该研究纳入了61名男性。表面置换关节成形术后患者的Cr（=0.019）和Co（=0.009）离子浓度平均值更高。与干骺端组相比，表面置换组观察到更高强度的氧化应激（巯基、丙二醛和脂褐素的活性）。金属对金属关节置换中的表面置换髋关节植入物比干骺端植入物在更大程度上提高了血液中Cr和Co离子的浓度，并与氧化应激和抗氧化系统的功能相关。
