Un manchon interposé de titane réduit-il la fréquence des pseudo-tumeurs après arthrosplatie totale de hanche métal-métal au recul de 5–7 ans - 22/12/16
Does a titanium sleeve reduce the frequency of pseudotumors in metal-on-metal total hip arthroplasty at 5–7 years follow-up?
, N. Egund b, I. Mechlenburg a, c, J. Gelineck b, S.S. Jakobsen a, K. Soballe a, d, M. Stilling a, eAbstract |
Introduction |
Little is known about pseudotumor frequency and risk factors for pseudotumor formation among different types of metal-on-metal (MoM) hip arthroplasties. A lower release of chromium and cobalt have been reported in MoM hip arthroplasties with a titanium sleeve compared to MoM designs without a titanium sleeve, but yet it is unknown whether a titanium sleeve reduces the pseudotumor frequence. We conducted a cross-sectional study to investigate: (1) pseudotumor frequency; (2) risk factors of pseudotumor formation; (3) and correlations between pseudotumors, serum metal-ions, implant position, and clinical symptoms.
Hypothesis |
We expected a lower pseudotumor frequency in MoM hip articulation with a titanium sleeve than reported in MoM hip articulation designs using chromium-cobalt sleeve.
Materials and method |
A consecutive series of 41 patients/49 hips (31 males), mean age 52 (28–68) years, participated in a 5.5±0.5 (4–6.5) year follow-up study of their M2a_Magnum hip articulation (Biomet Inc., Warsaw, Indiana, USA). Patients were evaluated with magnetic resonance imaging (MRI), measurements of serum metal-ions, plain radiographs, and clinical outcome measures of Harris Hip Score (HHS) and Oxford Hip Score (OHS).
Results |
Eighteen of 47 hips (38%) had MRI-verified pseudotumors, all cystic, with a mean dimension of 10.6×25.6×41mm. Digital measurements on plain radiographs revealed a higher cup anteversion in patients with a pseudotumor of mean 28.4°±5.05° compared to mean 23.5°±6.5° in patients without a pseudotumor (P=0.009). Serum metal-ion concentrations, acetabular cup inclination and measures of HHS and OHS were similar between patients with and without a pseudotumor (P>0.46).
Conclusion |
At 5.5±0.5 years after surgery, MRI-verified cystic pseudotumors were frequently observed in M2a_Magnum hip articulations despite the use of titanium sleeves. The pseudotumors were related to high cup anteversion angles but not related to high serum metal-ions or clinical symptoms.
Level of evidence |
IV: cross-sectional study.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Titanium sleeve, Metal-on-metal total hip arthroplasty, Magnetic resonance imaging, Pseudotumor, Serum metal-ion levels, Clinical outcome measures
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (www.sciencedirect.com/) en utilisant le DOI ci-dessus. |
Vol 102 - N° 8
P. 739 - Dicembre 2016 Ritorno al numero
Articolo precedente
- Les arthroplasties pour ostéonécrose de la tête fémorale ont-elles la même survie que celles pour arthrose primaire ? Étude cas témoin au recul moyen de 10 ans de 149 PTH pour nécrose versus 133 pour arthrose avec pivots anatomiques non cimentés et couple MoM 28 mm
- D. Ancelin, N. Reina, E. Cavaignac, S. Delclaux, P. Chiron
- Un petit offset fémoral est un facteur de risque d’atteinte du nerf cutané fémoral latéral au cours d’une arthroplastie de hanche par voie antérieure directe
- Y. Ozaki, Y. Homma, K. Sano, T. Baba, H. Ochi, A. Desroches, M. Matsumoto, T. Yuasa, K. Kaneko
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
Già abbonato a @@106933@@ rivista ?