- 作者：Olli S. Lainiala ; MDa ; Teemu P.S. Moilanen ; MD ; PhDa ; Alister J. Hart ; MD ; FRCSG(Orth)b ; Heini S.A. Huhtala ; MScc ; Shiraz A. Sabah ; MRCS ; BScb ; Antti P. Eskelinen ; MD ; PhDa ;
- 关键词：metal-on-metal ; resurfacing ; total hip arthroplasty ; cobalt ; chromium ; blood
- 刊名：The Journal of Arthroplasty
- 出版年：2016
- 出版时间：June 2016
- 年：2016
- 卷：31
- 期：6
- 页码：1261-1266
- 全文大小：296 K
Methods
From a single institution, blood Co and Cr levels were analyzed in 1748 patients (692 hip resurfacings and 1056 total hip arthroplasties [THAs]). Concentrations exceeding 7 ppb were considered elevated, and the risk factors for elevated levels were calculated with binary logistic regression.
Results
Elevated blood metal ion levels were more common in MoM THA than in resurfacing patients (17.4% vs 5.9%, P < .001), and in 5 of the 7 THA brands, more than 20% of patients had elevated metal ion concentrations, whereas the proportion was less than 10% in all hip resurfacings. In resurfacings, small femoral head (odds ratio [OR] 1.30 per millimeter decrease [CI, 1.12-1.49]), high acetabular inclination (OR 1.15 per degree increase [CI 1.09-1.22]), and young age (OR 1.05 per year decrease [1.02-1.10]) were independent risk factors for elevated ions. In the THA group, female gender (OR 2.04 [CI 1.35-3.06]), longer time between surgery and ion measurement (OR 1.19 per year increase [CI 1.05-1.34]), and large headsize (OR 1.07 per millimeter increase [CI 1.01-1.13]) were risk factors for elevated ions.
Conclusion
Given the high percentage of elevated levels, the systematic surveillance of especially large diameter MoM THAs seems justified.