金属对金属髋关节置换因金属颗粒不良反应翻修的研究进展

Research progress on the revision of Metal-on-Metal hip arthroplasty due to adverse reactions to metal debris

摩擦界面的选择在髋关节置换术中备受争议,金属对金属(metal-on-metal,MoM)的界面虽已慢慢淡出视野,但其翻修的问题却是临床的难点。金属颗粒的不良反应(adverse reactions to metal debris,ARMD)是金属对金属髋关节置换翻修最常见的适应证,且髋关节置换因ARMD行翻修的临床结果并不满意。目前,临床针对因ARMD行翻修所提出的指征及建议并不统一。本文就ARMD的临床诊断、翻修的适应证、预后的风险因素、术中建议、再翻修的原因等方面进行总结。简述髋关节置换因ARMD行翻修的诊疗策略及注意事项,拟在为临床上对此类患者行翻修手术提供参考。

The choice of friction interface has always been a controversial topic in hip arthroplasty.Although the metal-on-metal(MoM)interface has gradually faded out of our vision,its revision is a clinical difficulty.Adverse reactions to metal debris(ARMD)is the most common indication for MoM hip arthroplasty revision,and the clinical results of hip arthroplasty due to ARMD are not satisfactory.At present,the indications and suggestions for revision of ARMD are not uniform.In this article,the clinical diagnosis,indications of revision,risk factors of prognosis,intraoperative suggestions and reasons for revision of ARMD were summarized.This article briefly introduces the diagnosis and treatment strategies and precautions of hip arthroplasty due to ARMD,in order to provide reference for such patients in clinical practice.