Ｍｅｔａｌ‐ｏｎ‐Ｍｅｔａｌ型人工股関節の中期成績と問題点

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概要

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• Objective: Recent clinical studies with metal-on-metal total hiparthroplasty have shown mostly good results, and encouraging results have also been reported in active, high-demand patients. We reviewed the mid-term clinical and radiographic results of metal-on-metal total hip arthroplasty.Methods: Between February 1998 and Septem ber 2003, 42 primary total hip arthroplasties with the Metasul metal-on-metal articulation were performed in 38 patients, and the patients were monitored for at least 3 years. We evaluated them by means of the JOA score for clinical results and radio-graphic analysis after a mean follow-up time of 6.6 years.Results: The mean preoperative JOA score was 48.5 points, and it had improved to 94.5 points at the time of the final follow-up evaluation, Threehips (7,1%) were revised: two because of septic failure, and one because of frequent dislocation. Survivorship of metasul hip system at the time of the final follow-up examination (6.6 years) was 93.0% (end point: revision). The radio graphical analysis showed radiolucent lines around the cup and around the stem in 11.9% and 66.7%, respectively. However, there were no clear signs of loosening, migration, or osteolysis in relation to either the cup or stem comporlent in any of the patients.Conclusions: Our mid-term results with the use of the Metasul metal-on-metal articulation are encouraging. However, since some radiolucent lines were observed around the cups and the stems in this study, longer follow-up is necessary to identify osteolysis or any other possible long-term noxious effects associated with meta1-on-metal articulation.

• 日本関節病学会の論文

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