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Study on Metal Ion Release in Large Diameter Head Metal on Metal Totalhip Arthroplasty

Abstract第5-6页
摘要第7-9页
Contents第9-13页
List of Tables第13-15页
List of Figures第15-18页
List of Annexes第18页
List of Abbreviations第18-20页
Chapter 1 Introduction第20-26页
    1.1 Metal on metal hip replacement background and current challenges第20-23页
    1.2 Objectives of the study第23-24页
    1.3 Thesis structure第24-26页
Chapter 2 Literature Review第26-92页
    2.1 Introduction第26页
    2.2 History of early attempts at hip arthroplasty第26-32页
    2.3 History of metal on metal total arthroplasty第32-40页
        2.3.1 First generation MOM implants第32-36页
        2.3.2 Abandonment of first generation MOM implants第36-37页
        2.3.3 Second Generation MOM implants第37-40页
    2.4 Design concepts and Tribology of MOM implants第40-43页
        2.4.1 Cobalt, Chromium and Molybdenum alloys第40-41页
        2.4.2 Processing of Co, Cr, Mo alloys第41-43页
        2.4.3 Carbides in Co, Cr alloys and their effects第43页
    2.5 Design considerations第43-45页
        2.5.1 Geometry of the bearings第43-44页
        2.5.2 Load第44-45页
    2.6 Tribology第45-51页
        2.6.1 Friction第45-46页
        2.6.2 Lubrication第46-48页
        2.6.3 Function of the synovial fluid第48-51页
    2.7 Wear第51-55页
        2.7.1 Adhesive wear第52页
        2.7.2 Abrasive wear第52-53页
        2.7.3 Fatigue wear第53-54页
        2.7.4 Corrosive wear第54页
        2.7.5 Wear rates of MOM bearings第54-55页
    2.8 Corrosion第55-62页
        2.8.1 Types of corrosion第56-59页
        2.8.2 Tribo-corrosion第59-60页
        2.8.3 Effect of body fluids and pH on corrosion第60-61页
        2.8.4 Influence of proteins on corrosion第61-62页
    2.9 Tribology and improvements to MOM implants第62-67页
    2.10 Metal ions第67-79页
        2.10.1 Properties of Cobalt and Chromium第68-69页
        2.10.2 Literature on Metal Ion Levels following metal on metal arthroplasty第69-79页
    2.11 Adverse biological Effects related with metal ions第79-84页
        2.11.1 Carcinogenicity第80页
        2.11.2 Hypersensitivity第80-82页
        2.11.3 Genetic Damage第82-83页
        2.11.4 Trans-Placental transfer to the fetus第83-84页
    2.12 Clinical performance of MOM implants第84-89页
    2.13 Techniques of Metal Ion Analysis第89-90页
    2.14 Overview of literature review第90-92页
Chapter 3 Research Methodology第92-105页
    3.1 Introduction第92页
    3.2 Patients and Methods第92-95页
        3.2.1 Selection of patients and data collection第92-93页
        3.2.2 Blood sampling and processing第93页
        3.2.3 Analysis of Co, Cr and Ti第93-94页
        3.2.4 Radiological assessment第94-95页
    3.3 Implants used第95-97页
        3.3.1 Femoral stem第95-96页
        3.3.2 Femoral Head and neck length adaptor sleeves第96-97页
    3.4 Surgical procedure第97-103页
    3.5 Pre and Post Operative X-rays of patients with different diagnosis第103-105页
Chapter 4 Statistical Analysis第105-129页
    4.1 Introduction第105页
    4.2 Descriptive data analysis第105-108页
    4.3 Metal ion analysis第108-115页
        4.3.1 Analysis of Co levels第108-110页
        4.3.2 Analysis of Cr levels第110-113页
        4.3.3 Analysis of Ti Levels第113-115页
    4.4 Correlation analysis第115-122页
        4.4.1 Correlation between age and metal ions第115-119页
        4.4.2 Correlation between BMI and ion levels第119-122页
    4.5 Comparison of the levels of all three metals at all follow-up periods第122-125页
    4.6 Analysis of clinical outcome with HHS and UCLA score第125-128页
    4.7 Overview of statistical analysis第128-129页
Chapter 5第129-135页
    5.1 Discussion第129-134页
    5.2 Conclusion第134页
    5.3 Recommendations第134-135页
References第135-150页
Acknowledgements第150-152页
致谢第152-154页
ANNEX 1第154-155页
ANNEX 2第155-156页
ANNEX 3第156页

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