金属陶瓷髋关节置换术中腿部长度差异对金属离子释放的影响。

IF 0.5 4区 医学 Q4 ORTHOPEDICS Acta Ortopedica Brasileira Pub Date : 2023-01-01 DOI:10.1590/1413-785220233102e265272
Young-Ho Roh, Taehan Kang, Chaemoon Lim, Kwang Woo Nam
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摘要

目的:陶瓷对金属(CoM)轴承相对于陶瓷对陶瓷(CoC)和金属对金属(metal-on-metal)轴承具有理论上的优势。本研究旨在分析影响CoM轴承金属离子释放的因素,并比较其与CoC轴承的临床性能。方法:147例患者分为1组96例(CoM组)和2组51例(CoC组)。另外,在组1中,48例患者和30例患者被细分为腿长差异小于1cm的1- a组和大于1cm的1- b组。测定血清金属离子水平、功能评分及x线平片进行分析。结果:1组术后2年钴(Co)、1年铬(Cr)水平均明显高于2组。LLD与血清金属离子水平呈显著正相关。对比平均金属离子水平变化,1-B组金属离子水平高于1-A组。结论:在接受全髋关节置换术的患者中,大LLD有较高的金属离子相关并发症的风险。因此,在使用CoM轴承时,将LLD减小到1厘米或更小是至关重要的。证据等级III;病例对照研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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METAL ION RELEASE ACCORDING TO LEG LENGTH DISCREPANCY IN CERAMIC-ON-METAL HIP ARTHROPLASTY.

Objective: The ceramic-on-metal (CoM) bearing has the theoretical advantages over ceramic-on-ceramic (CoC) and metal-on-metal bearings. This study aimed to analyze factors affecting the metal ion release of CoM bearings and compare clinical performance with CoC bearings.

Methods: The 147 patients were divided into 96 patients in group 1 (CoM group) and 51 patients in group 2 (CoC group). Additionally, within group1, 48 patients and 30 patients were sub-categorized into group 1-A with leg length discrepancy (LLD) less than 1cm and group 1-B greater than 1 cm. The level of serum metal ions, functional scores and plain radiographs were obtained for the analysis.

Results: The level of cobalt (Co) 2-years after surgery and chromium (Cr) 1-year after surgery showed significantly higher in the group1 than the group2. LLD indicated statistically significant positive correlation between serum metal ion levels among CoM bearing THAs. In comparison of the average metal ions level changes, group 1-B showed higher level of metal ion than group 1-A.

Conclusion: In patients underwent THA with CoM bearings, large LLD have a higher risk of complications associated to metal ions. Therefore, it is critical to reduce the LLD to 1 cm or less in using CoM bearing. Level of Evidence III; Case Control Study.

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来源期刊
CiteScore
0.90
自引率
14.30%
发文量
67
审稿时长
25 weeks
期刊介绍: A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.
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