臨床整形外科49巻8号

2014年08月発行

Lecture

人工股関節全置換術後に発生するadverse reactions to metal debris（ARMD）

著者： 湏藤啓広¹

所属機関： ¹三重大学大学院医学系研究科整形外科学

ページ範囲：P.685 - P.690

はじめに

　表面置換型人工股関節とステムを有する通常型人工股関節からなるMetal-on-Metal人工股関節全置換術(THA)後に，adverse reactions to metal debris(ARMD)が発生することは周知の事実であり，その使用例は激減している．しかし，Metal-on-Polyethylene，Ceramic-on-Ceramic THAなど他の摺動面におけるARMD発生も報告されている．本稿では，日本におけるMetal-on-Metal THA後のARMD発生状況，Metal-on-Metal THA後の対処方法，他の摺動面を有する人工股関節におけるARMDについて最新の文献を中心に概説する．

参考文献

1) Engh CA, MacDonald SJ, Sritulanondha S, et al:Metal ion levels after metal-on-metal total hip arthroplasty. A five-year, prospective randomized trial. J Bone Joint Surg Am 96:448-455, 2014

2) Fehring TK, Odum S, Sproul R, et al:High frequency of adverse local tissue reactions in asymptomatic patients with metal-on-metal THA. Clin Orthop Relat Res 472:517-522, 2014

3) Garbuz DS, Hargreaves BA, Duncan CP, et al:Diagnostic accuracy of MRI versus ultrasound for detecting pseudotumors in asymptomatic metal-on-metal THA. Clin Orthop Relat Res 472:417-423, 2014

4) Hasegawa M, Yoshida K, Wakabayashi H, et al:Cobalt and chromium ion release after large-diameter metal-on-metal total hip arthroplasty. J Arthroplasty 27:990-996, 2012

5) Hasegawa M, Yoshida K, Wakabayashi H, et al:Prevalence of adverse reactions to metal debris following metal-on-metal THA. Orthopedics 36:e606-612, 2013

6) Higgs GB, Hanzlik JA, MacDonald DW, et al:Is increased modularity associated with increased fretting and corrosion damage in metal-on-metal total hip arthroplasty devices? A retrieval study. J Arthroplasty 28 (8 Suppl):2-6, 2013

7) Imanishi T, Hasegawa M, Sudo A:Serum metal ion levels after second-generation metal-on-metal total hip arthroplasty. Arch Orthop Trauma Surg 130:1447-1450, 2010

8) Jacobs JJ, Cooper HJ, Urban RM, et al:What do we know about taper corrosion in total hip arthroplasty? J Arthroplasty 29:668-669, 2014

9) Kwon YM, Lombardi AV, Jacobs JJ, et al:Risk stratification algorithm for management of patients with metal-on-metal hip arthroplasty. consensus statement of the American Association of Hip and Knee Surgeons, the American Academy of Orthopaedic Surgeons, and The Hip Society. J Bone Joint Surg Am 96:e4 (1-6), 2014

10) Lübbeke A, Rothman KJ, Garavaglia G, et al:Strong association between smoking and the risk of revision in a cohort study of patients with metal-on-metal total hip arthroplasty. J Orthop Res 32:762-768, 2014

11) Molloy DO, Munir S, Jack CM, et al:Fretting and corrosion in modular-neck total hip arthroplasty femoral stems. J Bone Joint Surg Am 96:488-493, 2014

12) Munro JT, Masri BA, Duncan CP, et al:High complication rate after revision of large-head metal-on-metal total hip arthroplasty. Clin Orthop Relat Res 472:523-528, 2014

13) Sugano N, Iida H, Akiyama H, et al:Nationwide investigation into adverse tissue reactions to metal debris after metal-on-metal total hip arthroplasty in Japan. J Orthop Sci 19:85-89, 2014

14) Tam HH, Bhaludin B, Rahman F, et al:SPECT-CT in total hip arthroplasty. Clin Radiol 69:82-95, 2014

15) Whitehouse MR, Endo M, Masri BA:Adverse local tissue reaction associated with a modular hip hemiarthroplasty. Clin Orthop Relat Res 471:4082-4086, 2013