BMJ Open：血钴浓度高或可预示髋关节置换失败

　　英国一项研究显示，血钴浓度升高与继发于金属碎屑所致不良反应的金属对金属（MoM）髋关节表面置换早期失败相关。论文3月12日在线发表于《英国医学杂志》（BMJ Open）。

　　该队列研究共纳入278例患者，结果为，血钴浓度是关节置换失败的显著危险因素（z=8.44，P=2×10-16），血钴浓度＞20 μg/L常与骨质溶解相关（图2）。考克斯比例风险模型分析显示，男性发生关节置换失败的风险较女性低66%（z=-2.29429，P=0.0218）。女性患者发生软组织损伤的情况似乎更复杂；当暴露于同等金属碎屑水平的环境下，行关节表面置换术（ASR）的患者似乎发生关节置换失败的风险更高。

与关节置换相关的拓展阅读：

• BMJ Open：血钴浓度高或可预示髋关节置换失败
• AAOS 2013：≤55岁全髋关节置换术（THA）患者翻修失败率更高
• AAOS 2013：全髋关节置换术（THA）前路与后路手术疗效相似
• 微创人工全髋关节置换术与传统置换术临床疗效的Meta分析
• AAOS 2013：全膝关节置换术（TKA）术后工作恢复率达99%
• AAOS 2013：抑郁与全关节置换术（TJA）术后并发症风险增加有关
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原文阅读：Metal Ions Point to MoM Hip Failure
Cobalt ion levels in blood were significantly higher in asymptomatic patients who later needed revision of two types of metal-on-metal hip replacement, suggesting that a screening program based on metal ion testing would be valuable, researchers said.
Among patients receiving hip resurfacing systems made by Smith & Nephew or the DePuy unit of Johnson & Johnson at one British hospital, blood cobalt levels following implantation were strongly correlated with subsequent risk of revision in both men and women (z=8.44, p=2×10-16), reported David Langton, MRCS, of the University Hospital of North Tees in Middlesbrough, England, and colleagues....