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금속-금속 관절면 고관절 인공관절 치환술

Metal-on-metal Articulation of Total Hip Replacement

한석구
대한고관절학회 (The Korean Hip Society)|2013.12|Hip and Pelvis|제25권 제4호|pp. 245-253|DOI http://dx.doi.org/10.5371/hp.2013.25.4.245

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참고문헌

키워드

인공 고관절 전치환술Total hip replacement금속 이온Metal ionsMetal-on-metal articulation금속-금속 관절면금속 마모입자Metal particles

초록

금속-금속 관절면 인공관절물은 마모가 적고 골두 크기가 크기때문에 관절의 안정성이 있다는 장점이있으며 마모기전, 마찰학, 윤활기전 및 발생하는 마모입자 등에 금속-폴리에틸렌 관절면 인공고관절치환물과 차이가 있다. 2세대 금속-금속 관절면 인공고관절 전치환술의 중, 장기적 임상결과는 우수하다고 알려져 있으나 마모된 금속입자와 금속이온이 국소적 및 전신적으로 미치는 여러 부정적 영향에 대한 가능성은 아직 해결되지 않은 숙제로 남아 있다. 최근 금속 마모입자와 금속이온에 의한 연부조직 반응이 큰 문제가 되었고, 일부 표면 관절치환 인공관절물의 높은 재치환율이 보고되면서 퇴출되는 사태까지 초래되었다. 이에 저자는 금속-금속 관절면 인공관절의 역사, 마찰학(tribology), 금속마모입자 및 금속이온의 생물학적 영향 및 금속-금속 관절면 고관절 전치환술의 임상적 결과 및 최근이슈가 되고 있는 금속-금속 관절면표면 관절치환술의 현황 등을 고찰하고자 한다.

Abstract

Metal-on-metal (MoM) total hip replacement (THR) and hip resurfacing have an advantage of low wear rate andgreater stability by larger head size and different characteristics of wear mechanism, tribology, lubrication orgenerating wear debris compared to conventional metal-on-polyethylene THR. Although the mid- or long termclinical reports of second generation MoM THR were excellent, concerns about local and systemic effect bymetal particles or metal ions were remained. Recently, reports have emerged of abnormal soft-tissue reactions tometal particles or metal ions and some hip resurfacing implants were expelled from the market due to highrevision rate. This article includes the history of MoM THR, tribology, the biologic effect of metal particles andions, the clinical results of MoM THR and the issues regarding the problems associated with hip resurfacing.

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관련 논문AI추천

고관절 전치환술에서의 금속-금속 관절면박윤수, 임승재대한고관절학회 · Hip and Pelvis2010 · 제22권 제3호고관절 전치환술에서의 금속-금속 관절면성열보대한고관절학회 · Hip and Pelvis2006 · 제18권 제4호금속-금속 관절면을 이용한 인공고관절 전치환술박신승, 성열보대한고관절학회 · Hip and Pelvis2008 · 제20권 제2호고관절 전치환술에서의 금속-금속 관절면김영호, 박기철대한고관절학회 · Hip and Pelvis2004 · 제16권 제2호2세대 Metal-on-Metal prosthesis를 사용한 무시멘트 인공고관절 전치환술 중간 결과보고(5-10년)곽희철, 김영창, 김주용, 정경칠대한고관절학회 · Hip and Pelvis2004 · 제16권 제1호금속 대 금속 관절면을 이용한 고관절 표면 치환술-최소 3년 추시 결과-권세원, 박종석, 서유성, 우승한, 이상선, 최호림, 홍창화대한고관절학회 · Hip and Pelvis2008 · 제20권 제1호

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