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Establishing thresholds for metal ion levels in patients with bilateral Articular Surface Replacement hip arthroplasty.
Donahue, Gabrielle S; Galea, Vincent P; Laaksonen, Inari; Connelly, James W; Muratoglu, Orhun; Malchau, Henrik.
Afiliação
  • Donahue GS; The Harris Orthopaedics Laboratory, Massachusetts General Hospital, Boston, MA, USA.
  • Galea VP; The Harris Orthopaedics Laboratory, Massachusetts General Hospital, Boston, MA, USA.
  • Laaksonen I; The Harris Orthopaedics Laboratory, Massachusetts General Hospital, Boston, MA, USA.
  • Connelly JW; The Harris Orthopaedics Laboratory, Massachusetts General Hospital, Boston, MA, USA.
  • Muratoglu O; The Harris Orthopaedics Laboratory, Massachusetts General Hospital, Boston, MA, USA.
  • Malchau H; The Harris Orthopaedics Laboratory, Massachusetts General Hospital, Boston, MA, USA.
Hip Int ; 29(5): 475-480, 2019 Sep.
Article em En | MEDLINE | ID: mdl-29987949
ABSTRACT

INTRODUCTION:

The primary aim of the current study was to determine whether metal ion levels could identify well- from poorly-functioning implants in patients after undergoing bilateral Articular Surface Replacement (ASR) Hip System. The secondary aim was to establish threshold values for Co and Cr that could be used to predict clinical problems in these patients. MATERIALS AND

METHODS:

The study included 125 patients treated with bilateral ASR hip resurfacing (HRA) and 93 patients treated with bilateral ASR XL total hip arthroplasty (THA) at a mean follow-up of 7.1 years post-surgery. Patients were labelled as well- or poorly-functioning based on strict criteria. We calculated the Co and Cr safe upper ion limits (SUL) for ASR HRA and ASR XL THA separately and assessed these cutoffs ability to predict clinical problems.

RESULTS:

In patients with bilateral ASR HRA, the well-functioning group had lower ions than the poorly-functioning. In ASR THA patients, there was no difference in blood Co or Cr levels between well- and poorly-functioning implant groups (p = 0.118 and p = 0.379, respectively). Both Co and Cr could effectively discriminate between well-functioning and poorly-functioning ASR HRA implants (p < 0.001 and p < 0.001, respectively), but not for ASR THA implants (p = 0.118 and p = 0.564, respectively). SULs of 4.0 ppb for Co and 4.0 ppb for Cr could differentiate between well- and poorly-functioning implants with high specificity.

CONCLUSIONS:

Metal ion levels are a more reliable tool in MoM HRA than THA when discriminating well- from poorly-functioning implants in bilateral patients. For patients treated with bilateral ASR HRA, ion levels above 4.0 ppb are highly specific for the detection of clinical problems.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Artroplastia de Quadril / Próteses Articulares Metal-Metal / Metais Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Hip Int Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Artroplastia de Quadril / Próteses Articulares Metal-Metal / Metais Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Hip Int Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Estados Unidos