低过敏性膝关节假体的使用和临床效果:它们安全有效吗?

IF 1.5 Q3 ORTHOPEDICS Arthroplasty Today Pub Date : 2024-08-01 DOI:10.1016/j.artd.2024.101399
Feng Xie MD, PhD , Shuya Sheng , Venkatesh Ram FRCS (Tr & Orth) , Hemant Pandit MD, PhD
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引用次数: 0

摘要

背景现代全膝关节置换术(TKA)中争论最多的话题之一是金属过敏症(MH)作为假体失败潜在原因的影响。在疑似 MH 的病例中,植入低过敏性假体以避免潜在问题是一种可用于此类病例的治疗方案。方法对所有与现代低过敏性种植体相关的文献进行了回顾和总结,以提供一份全面的概要。此外,我们还在 PUBMED、MEDLINE 和 Google Scholar 上进行了详细的文献检索,以确定所有报告低过敏性膝关节植入物疗效的临床研究。我们的搜索仅限于 2018 年 7 月至 2023 年 7 月期间以英文发表的完整手稿研究。结果为了最大限度地降低 MH 风险,已经开发出了新的植入体变体,这些变体要么正在接受临床评估,要么已投入常规临床使用。其中包括带有保护涂层(单层或多层)的传统金属植入物和无金属植入物。结论已发表的研究和关节置换登记数据分析显示,低过敏性和标准 TKA 之间没有显著差异,总体存活率良好。今后需要进一步开展高质量的研究,以更好地了解这一问题的复杂性。
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Hypoallergenic Knee Implant Usage and Clinical Outcomes: Are They Safe and Effective?

Background

One of the most debated topics in modern total knee arthroplasty (TKA) is the impact of metal hypersensitivity (MH) as a potential cause of prosthesis failure. Implanting hypoallergenic prostheses to avoid potential problems in suspected cases of MH is one treatment option that can be used in such cases. However, their long-term clinical safety and efficacy are not well proven.

Methods

All literature relevant to modern hypoallergenic implants were reviewed and summarized to provide a comprehensive synopsis. In addition, a detailed literature search was performed on PUBMED, MEDLINE, and Google Scholar to identify all the clinical studies reporting outcomes for hypoallergenic knee implants. Our search was confined to those studies published as full manuscripts in the English language from July 2018 to July 2023.

Results

To minimize the risk of MH, new implant variants have been developed which are either under clinical evaluation or in routine clinical use. These include conventional metal implants with protective coatings (mono- or multilayer) and metal-free implants. However, there is insufficient clinical data to confirm the rationale and effectiveness of using these “hypoallergenic” TKA implants.

Conclusions

Published studies and arthroplasty registry data analyses indicate no significant differences between hypoallergenic and standard TKAs with overall good survival rates. In the future, further high-quality studies are needed to better understand the complexity of this subject.

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来源期刊
Arthroplasty Today
Arthroplasty Today Medicine-Surgery
CiteScore
2.90
自引率
0.00%
发文量
258
审稿时长
40 weeks
期刊介绍: Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.
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