PDF(Pubmed)
Abstract：
Concerns have emerged regarding elevated levels of cobalt and chromium in patients with metal-on-metal megaprostheses. This prospective study aims to identify systemic cobalt and chromium levels in metal-on-polyethylene knee and hip megaprostheses and their associations with other factors.
56 patients underwent knee or hip megaprosthesis surgery at 2 sarcoma centers. Serum cobalt and chromium levels were measured preoperatively and thrice within the first year using inductively coupled plasma mass spectrometry.
A statistically significant difference in serum cobalt levels (1.4 ppb; 95% confidence interval [CI] 0.0-3.3) was observed 1 year after knee megaprosthesis surgery compared with preoperative levels. In contrast no difference in chromium levels was observed after 1 year compared with preoperative levels (0.05 ppb; CI 0.0-0.8). An association between younger age, higher eGFR, and increased cobalt levels was observed. No significant correlations were found between ion levels and resection length or the number of modular connections.
We found elevated serum ion levels in metal-on-polyethylene knee megaprostheses in contrast to metal-on-polyethylene hip megaprostheses. Furthermore, a positive correlation between cobalt and chromium levels, and between cobalt and eGFR was identified, along with a negative correlation between cobalt and age. This study highlights the importance of monitoring systemic cobalt and chromium levels in patients with megaprostheses.
56 patients underwent knee or hip megaprosthesis surgery at 2 sarcoma centers. Serum cobalt and chromium levels were measured preoperatively and thrice within the first year using inductively coupled plasma mass spectrometry.
A statistically significant difference in serum cobalt levels (1.4 ppb; 95% confidence interval [CI] 0.0-3.3) was observed 1 year after knee megaprosthesis surgery compared with preoperative levels. In contrast no difference in chromium levels was observed after 1 year compared with preoperative levels (0.05 ppb; CI 0.0-0.8). An association between younger age, higher eGFR, and increased cobalt levels was observed. No significant correlations were found between ion levels and resection length or the number of modular connections.
We found elevated serum ion levels in metal-on-polyethylene knee megaprostheses in contrast to metal-on-polyethylene hip megaprostheses. Furthermore, a positive correlation between cobalt and chromium levels, and between cobalt and eGFR was identified, along with a negative correlation between cobalt and age. This study highlights the importance of monitoring systemic cobalt and chromium levels in patients with megaprostheses.
摘要：
目的：对金属对金属巨型假体患者钴和铬水平升高的担忧已经出现。这项前瞻性研究旨在确定金属对聚乙烯膝盖和臀部巨型假体中的系统性钴和铬水平及其与其他因素的关系。
方法：56例患者在2个肉瘤中心接受了膝关节或髋关节大型假体手术。术前和第一年内使用电感耦合等离子体质谱法测量血清钴和铬水平。
结果：膝关节大型假体手术后1年，血清钴水平与术前水平相比有统计学上的显着差异（1.4ppb；95％置信区间[CI]0.0-3.3）。相比之下，1年后与术前相比，铬水平没有差异（0.05ppb；CI0.0-0.8）。年轻之间的联系，较高的eGFR，并观察到钴含量增加。在离子水平与切除长度或模块化连接数量之间没有发现显着相关性。
结论：我们发现，与金属对聚乙烯髋部巨型假体相比，金属对聚乙烯膝部巨型假体的血清离子水平升高。此外，钴和铬水平之间的正相关，在钴和eGFR之间进行了鉴定，钴与年龄呈负相关。这项研究强调了监测大型假体患者全身钴和铬水平的重要性。
方法：56例患者在2个肉瘤中心接受了膝关节或髋关节大型假体手术。术前和第一年内使用电感耦合等离子体质谱法测量血清钴和铬水平。
结果：膝关节大型假体手术后1年，血清钴水平与术前水平相比有统计学上的显着差异（1.4ppb；95％置信区间[CI]0.0-3.3）。相比之下，1年后与术前相比，铬水平没有差异（0.05ppb；CI0.0-0.8）。年轻之间的联系，较高的eGFR，并观察到钴含量增加。在离子水平与切除长度或模块化连接数量之间没有发现显着相关性。
结论：我们发现，与金属对聚乙烯髋部巨型假体相比，金属对聚乙烯膝部巨型假体的血清离子水平升高。此外，钴和铬水平之间的正相关，在钴和eGFR之间进行了鉴定，钴与年龄呈负相关。这项研究强调了监测大型假体患者全身钴和铬水平的重要性。
