Healy W L, Wasilewski S A, Pfeifer B A, Kurtz S R, Hallack G N, Valerio M, Valeri R
Department of Orthopaedic Surgery, Lahey Clinic Medical Center, Burlington, Massachusetts 01805.
Clin Orthop Relat Res. 1993 Jan(286):15-7.
Twenty-five patients were prospectively evaluated to quantify levels of methylmethacrylate monomer and fat in systemic blood and in shed blood after total joint arthroplasty. Levels of methylmethacrylate monomer in systemic blood were measured at intervals after insertion of the prosthesis. Levels of methylmethacrylate monomer in shed blood were measured at intervals after insertion of the drain. Levels of fat in systemic blood were measured preoperatively and 30 minutes after insertion of the prosthesis. Levels of fat in shed blood were measured 60 minutes after insertion of the drain. No significant fat or methylmethacrylate monomer was noted in systemic blood. Levels of methylmethacrylate monomer in shed blood were highest five minutes after insertion of the drain. Levels of methylmethacrylate monomer in shed blood collected from the hip were significantly lower than levels in shed blood from the knee. Levels of shed blood from the hip and knee were undetectable six hours after insertion of the drain. Shed blood from the hips and knees contained fat particles of three diameters: fat particles less than 9 microns, 9-40 microns, and greater than 40 microns. The diameter of most of the fat particles in the shed blood was less than 9 microns. Fat particles less than 40 microns in diameter will not be removed by microaggregate screen filters 40 microns in diameter.
对25例患者进行前瞻性评估，以量化全关节置换术后全身血液和引流血液中甲基丙烯酸甲酯单体和脂肪的水平。在植入假体后定期测量全身血液中甲基丙烯酸甲酯单体的水平。在插入引流管后定期测量引流血液中甲基丙烯酸甲酯单体的水平。在术前和植入假体后30分钟测量全身血液中的脂肪水平。在插入引流管后60分钟测量引流血液中的脂肪水平。在全身血液中未发现明显的脂肪或甲基丙烯酸甲酯单体。引流血液中甲基丙烯酸甲酯单体的水平在插入引流管后5分钟时最高。从髋关节收集的引流血液中甲基丙烯酸甲酯单体的水平明显低于膝关节引流血液中的水平。插入引流管6小时后，髋关节和膝关节的引流血液无法检测到。髋关节和膝关节的引流血液中含有三种直径的脂肪颗粒：直径小于9微米、9 - 40微米和大于40微米的脂肪颗粒。引流血液中大多数脂肪颗粒的直径小于9微米。直径小于40微米的脂肪颗粒不会被直径40微米的微聚体滤网滤除。
