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首页> 外文期刊>The Journal of Bone and Joint Surgery. British VolumecBritish Orthopaedic Association , Australian Orthopaedic Association , Canadian Orthopaedic Association . . . [et al] >Metal ion release from bearing wear and corrosion with 28 mm and large-diameter metal-on-metal bearing articulations: A follow-up study
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Metal ion release from bearing wear and corrosion with 28 mm and large-diameter metal-on-metal bearing articulations: A follow-up study

机译：28 mm 和大直径金属对金属轴承铰接的轴承磨损和腐蚀释放的金属离子：后续研究

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摘要

We have updated our previous randomised controlled trial comparing release of chromium (Cr) and cobalt (Co) ions and included levels of titanium (Ti) ions. We have compared the findings from 28 mm metal-on-metal total hip replacement, performed using titanium CLS/ Spotorno femoral components and titanium AlloFit acetabular components with Metasul bearings, with Durom hip resurfacing using a Metasul articulation or bearing and a titanium plasma-sprayed coating for fixation of the acetabular component. Although significantly higher blood ion levels of Cr and Co were observed at three months in the resurfaced group than in total hip replacement, no significant difference was found at two years post-operatively for Cr, 1.58 μg/L and 1.62 μg/L respectively (p = 0.819) and for Co, 0.67 μg/L and 0.94 μg/L respectively (p = 0.207). A steady state was reached at one year in the resurfaced group and after three months in the total hip replacement group. Interestingly, Ti, which is not part of the bearing surfaces with its release resulting from metal corrosion, had significantly elevated ion levels after implantation in both groups. The hip resurfacing group had significantly higher Ti levels than the total hip replacement group for all periods of follow-up. At two years the mean blood levels of Ti ions were 1.87 μg/L in hip resurfacing and and 1.30 μg/L in total hip replacement (p = 0.001). The study confirms even with different bearing diameters and clearances, hip replacement and 28 mm metal-on-metal total hip replacement produced similar Cr and Co metal ion levels in this randomised controlled trial study design, but apart from wear on bearing surfaces, passive corrosion of exposed metallic surfaces is a factor which influences ion concentrations. Ti plasma spray coating the acetabular components for hip resurfacing produces significantly higher release of Ti than Ti grit-blasted surfaces in total hip replacement.
机译：我们更新了之前的随机对照试验，比较了铬 （Cr） 和钴 （Co） 离子的释放，并纳入了钛 （Ti） 离子的水平。我们比较了 28 mm 金属对金属全髋关节置换术的结果，使用钛 CLS/Spotorno 股骨组件和钛合金 AlloFit 髋臼组件和 Metasul 轴承进行，使用 Metasul 关节或轴承进行 Durom 髋关节表面置换，并使用钛等离子喷涂涂层固定髋臼组件。尽管在表面置换术组的 3 个月时观察到 Cr 和 Co 的血离子水平明显高于全髋关节置换组，但在术后 2 年，Cr 分别为 1.58 μg/L 和 1.62 μg/L （p = 0.819），Co 分别为 0.67 μg/L 和 0.94 μg/L （p = 0.207）。在重新浮出水面的组中，在一年时达到稳定状态，在全髋关节置换组中，在三个月后达到稳定状态。有趣的是，由于金属腐蚀而释放的不是轴承表面一部分的钛，在两组植入后离子水平显着升高。在所有随访期间，髋关节表面置换术组的 Ti 水平显着高于全髋关节置换组。两年时，髋关节置换术中钛离子的平均血液水平为 1.87 μg/L，全髋关节置换术中为 1.30 μg/L （p = 0.001）。该研究证实，即使在轴承直径和间隙不同的情况下，髋关节置换术和 28 毫米金属对金属全髋关节置换术在这项随机对照试验研究设计中产生的 Cr 和 Co 金属离子水平相似，但除了轴承表面的磨损外，暴露金属表面的被动腐蚀是影响离子浓度的一个因素。在全髋关节置换术中，髋关节表面置换术的髋臼组件的钛等离子喷涂涂层产生的钛释放量明显高于钛喷砂表面。

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