战创伤复杂性骨折外固定治疗的研究.pptVIP

Ten-year outcome of serum metal ion levels after primary total hip arthroplasty: a concise follow-up of a previous report Levine BR, et al. Rush University Medical Center J Bone Joint Surg Am. 2013 Mar 20;95(6):512-8. Background Adverse local and systemic effects: Local soft tissue reactions Pseudotumor formation Systemic effects End-organ deposition Serum metal levels are not unique to metal-on-metal bearings All metallic components potentially resulting in the formation of chemically active metal degradation products Implants became more durable and increase longevity, demographic change There is no accepted threshold to be toxic in patients Original report: Observe 3 years follow-up Present study: determine the serum metal concentrations with metal-on-polyethylene on 10 years follow-up Background All prostheses were inserted from 1989 – 1993 No other metallic implants used Study：55（primary unilateral THA）； Control： 20 Methods hybrid group: cobalt-alloy cemented femoral stem with titanium acetabular socket without cement CoCr group: cobalt-chromium without cement Titanium group: titanium-alloy without cement Control group: no metal implant hybrid group: coblat-alloy femoral stem cemented 28-mm-diameter cobalt-alloy head titanium acetabular non-cemented titanium screw (Zimmer) CoCr group: Duraloc, AML, Solution, Prodigy(Depuy) Titanium group: Harris-Galante porous-coated (Zimmer) Metal ion concentrations in patient serum were analyzed by high-resolution plasma mass spectrometry The concentration of cobalt in the serum: hybrid group is 3.2 times higher than the baseline at 120 month, and significantly different than Ti. Co The concentration of chromium in the serum: hybrid group is 3.9