Background: Metal implants have been preferentially used in THA due to its biocompatibility, mechanical stability and durability. Yet concerns have emerged regarding their potential to release metallic ions, leading to long-term adverse effects, including carcinogenicity. This study aimed to investigate the risk of cancer development in patients with orthopaedic metal implants in total hip arthroplasty (THA). Methods: Patients with THA conducted at a local tertiary implant centre from 2001–2008 were linked to the local cancer registry and followed up to the end of 2023. Standardized incidence ratios (SIRs) for cancer incidence and its confidence interval by Poisson distribution were calculated. Survival analysis was depicted using the Kaplan–Meier method, and the log-rank test was used to assess the differences across groups. Results: The study cohort included 388 patients and 53 cancers diagnosed during follow-up, at least 5 years post THA. All-site cancer risks were increased in patients with THA (SIR: 1.97; 95% CI: 1.48–2.46), validated with chi-square analysis (chi-square = 15.2551, N = 100,388,p< 0.01). A statistically significant increase in multiple site-specific cancers including haematological cancers were identified. Conclusions: Patients with THA were found to have an increased risk for cancer compared to the general population during a mean follow-up of 16 years.
背景：金属植入物因其良好的生物相容性、机械稳定性和耐用性，在全髋关节置换术（THA）中常被优先选用。然而，关于其可能释放金属离子并导致包括致癌性在内的长期不良影响的担忧日益显现。本研究旨在探讨接受全髋关节置换术并使用骨科金属植入物的患者罹患癌症的风险。 方法：本研究将2001年至2008年间在一家地方三级植入中心接受全髋关节置换术的患者与地方癌症登记系统进行关联，并随访至2023年底。通过泊松分布计算了癌症发病的标准化发病率比（SIRs）及其置信区间。使用Kaplan-Meier方法描绘生存分析曲线，并采用对数秩检验评估组间差异。 结果：研究队列包括388名患者，在THA术后至少5年的随访期间，共诊断出53例癌症。THA患者的全癌种风险有所增加（SIR: 1.97; 95% CI: 1.48–2.46），卡方分析验证了此结果（卡方值 = 15.2551, N = 100,388, p < 0.01）。研究发现，包括血液系统癌症在内的多个特定部位癌症的发病率存在统计学上的显著增加。 结论：在平均16年的随访期内，与普通人群相比，接受全髋关节置换术的患者被发现具有更高的患癌风险。
Cancer-Causing Effects of Orthopaedic Metal Implants in Total Hip Arthroplasty
肿瘤(癌症)患者之家