Osteolysis in total hip arthroplasty in relation to metal ion release: Comparison between monolithic prostheses and different modularities  

作　　者：Francesco Manfreda Egzon Bufi Enrico Francesco Florio Paolo Ceccarini Giuseppe Rinonapoli Auro Caraffa Pierluigi Antinolfi 

机构地区：[1]Division of Orthopedics and Trauma Surgery,Santa Maria della Misericordia Hospital,Perugia 06100,Italy [2]Department of Orthopedics and Traumatology,University of Perugia,Perugia 06100,Italy [3]Department of Orthopaedic and Traumatology,Infermi Hospital,AUSL Romagna,Rimini 47921,Italy [4]Department of Orthopaedic,University of Perugia,Perugia 06100,Italy

出　　处：《World Journal of Orthopedics》2021年第10期768-780,共13页世界骨科杂志（英文版）

摘　　要：BACKGROUND Among the various complications associated with total hip arthroplasty(THA)periprosthetic osteolysis and wear phenomena due to the release of metal particles,are two of the most common and have been reported to be correlated because of inflammatory responses directed towards released particles that generally activate macrophagic osteolytic effects.Therein,new masses known as pseudotumors can appear in soft tissues around a prosthetic implant.To date,there is paucity of reliable data from studies investigating for any association between the above mentioned adverse events.AIM To investigate for the existence of any association between serum and urine concentrations of metal-ions released in THA and periprosthetic osteolysis for modular neck and monolithic implants.METHODS Overall,76 patients were divided into three groups according to the type of hip prosthesis implants:Monoblock,modular with metal head and modular with ceramic head.With an average f-up of 4 years,we conducted a radiological evaluation in order to detect any area of osteolysis around the prosthesis of both the femur and the acetabulum.Moreover,serum and urinary tests were performed to assess the values of Chromium and Cobalt released.Statistical analysis was performed to determine any association between the ion release and osteolysis.RESULTS For the 3 study groups,the monolithic,modular ceramic-headed and modular metal-headed implants had different incidences of osteolysis events,which were higher for the modular implants.Furthermore,the most serious of these(grade 3)were detected almost exclusively for the modular implants with metal heads.A mapping of the affected areas was performed revealing that the highest incidences of osteolysis were evidenced in the pertrochanteric region at the femur level,and in the supero-external region at the acetabular level.Regarding the evaluation of the release of metals-ions from wear processes,serum and urinary chromium and cobalt values were found to be higher in cases of modularity,and even more s

关 键 词：Total hip arthroplasty Peri-prosthetic osteolysis METAL-IONS Monolithic total hip arthroplasty Modular ceramic headed total hip arthroplasty Modular metallic headed total hip arthroplasty 

分 类 号：R687.4[医药卫生—骨科学]