• 主页
  • 查找结果
  • Raised levels of metal ions in the blood in patients who have undergone uncemented metal-on-polyethylene Trident-Accolade total hip replacement.

Raised levels of metal ions in the blood in patients who have undergone uncemented metal-on-polyethylene Trident-Accolade total hip replacement.

The bone & joint journal (2014-01-08)
P Craig, G Bancroft, A Burton, S Collier, P Shaylor, A Sinha
摘要

The issues surrounding raised levels of metal ions in the blood following large head metal-on-metal total hip replacement (THR), such as cobalt and chromium, have been well documented. Despite the national popularity of uncemented metal-on-polyethylene (MoP) THR using a large-diameter femoral head, few papers have reported the levels of metal ions in the blood following this combination. Following an isolated failure of a 44 mm Trident-Accolade uncemented THR associated with severe wear between the femoral head and the trunnion in the presence of markedly elevated levels of cobalt ions in the blood, we investigated the relationship between modular femoral head diameter and the levels of cobalt and chromium ions in the blood following this THR. A total of 69 patients received an uncemented Trident-Accolade MoP THR in 2009. Of these, 43 patients (23 men and 20 women, mean age 67.0 years) were recruited and had levels of cobalt and chromium ions in the blood measured between May and June 2012. The patients were then divided into three groups according to the diameter of the femoral head used: 12 patients in the 28 mm group (controls), 18 patients in the 36 mm group and 13 patients in the 40 mm group. A total of four patients had identical bilateral prostheses in situ at phlebotomy: one each in the 28 mm and 36 mm groups and two in the 40 mm group. There was a significant increase in the mean levels of cobalt ions in the blood in those with a 36 mm diameter femoral head compared with those with a 28 mm diameter head (p = 0.013). The levels of cobalt ions in the blood were raised in those with a 40 mm diameter head but there was no statistically significant difference between this group and the control group (p = 0.152). The levels of chromium ions in the blood were normal in all patients. The clinical significance of this finding is unclear, but we have stopped using femoral heads with a diameter of ≤ 36 mm, and await further larger studies to clarify whether, for instance, this issue particularly affects this combination of components.

材料
货号
品牌
产品描述

Sigma-Aldrich
聚乙烯, low density, melt index 25 g/10 min (190°C/2.16kg)
聚乙烯 (LDPE), ERM®, certified reference material
Sigma-Aldrich
聚乙烯, average Mw ~4,000 by GPC, average Mn ~1,700 by GPC
Sigma-Aldrich
聚乙烯, Ultra-high molecular weight, surface-modified, powder, 34-50 μm particle size
Sigma-Aldrich
铬, chips, 99.995% trace metals basis
Sigma-Aldrich
聚乙烯, Ultra-high molecular weight, average Mw 3,000,000-6,000,000
Sigma-Aldrich
铬, powder, ≥99% trace metals basis, <45 μm
Sigma-Aldrich
钴, powder, <150 μm, ≥99.9% trace metals basis
Sigma-Aldrich
钴, powder, 2 μm particle size, 99.8% trace metals basis
Sigma-Aldrich
聚乙烯, Ultra-high molecular weight, surface-modified, powder, 125 μm avg. part. size
Sigma-Aldrich
聚乙烯, High density, melt index 2.2 g/10 min (190 °C/2.16kg)
Sigma-Aldrich
聚乙烯, Medium density
Sigma-Aldrich
聚乙烯, Linear low density, melt index 1.0 g/10 min (190°C/2.16kg)
Sigma-Aldrich
聚乙烯, High density, melt index 12 g/10 min (190 °C/2.16kg)
Sigma-Aldrich
铬, powder, 99.5%, −100 mesh
Sigma-Aldrich
钴, Carbon coated magnetic, nanopowder, <50 nm particle size (TEM), ≥99%
Sigma-Aldrich
钴, granular, 99.99% trace metals basis
Sigma-Aldrich
钴, foil, thickness 0.1 mm, 99.95% trace metals basis
Supelco
聚乙烯, analytical standard, for GPC, 2,000
Sigma-Aldrich
钴, pieces, 99.5% trace metals basis
Sigma-Aldrich
钴, wire, diam. 1.0 mm, 99.995% trace metals basis
Sigma-Aldrich
铬, chips, thickness ~2 mm, 99.5%
Sigma-Aldrich
钴, foil, thickness 0.25 mm, ≥99.99% trace metals basis
Sigma-Aldrich
铬, sputtering target, diam. × thickness 3.00 in. × 0.125 in., 99.95% trace metals basis
Sigma-Aldrich
聚乙烯, average Mw ~35,000 by GPC, average Mn ~7,700 by GPC
Sigma-Aldrich
钴, foil, thickness 1.0 mm, 99.95% trace metals basis
Sigma-Aldrich
钴, rod, diam. 5.0 mm, 99.95% trace metals basis
Sigma-Aldrich
钴, rod, diam. 5.0 mm, 99.998% trace metals basis
Sigma-Aldrich
钴, foil, thickness 0.1 mm, ≥99.99%