Joint replacement with metal implants has been the standard procedure for surgical treatment of irreversible degeneration of hip and knee joints for more than two decades.
However, reports of local malignancy after joint replacement and experimental studies that suggest a carcinogenic action of metal ions and polymethylmethacrylate have raised concern about the possible long-term risks associated with metal implants.
Our aim was to study cancer risk in a Swedish cohort of patients who had hip replacement surgery during the period 1965 through 1983.
We studied the risk of cancer in a cohort of 39 154 patients, identified in the nationwide Swedish Inpatient Register with at least one hip replacement during the period 1965 through 1983.
The overall relative risk of cancer was increased by only 3%. Bone cancer-the focus of previous concerns-occurred in six cases versus 4.3 expected, and connective tissue cancer occurred in 28 cases versus 25.9 expected.
In this study, the largest study to date to evaluate hip replacement and subsequent cancer risk, the overall cancer risk appears to be negligible from a public health perspective, and our results have not produced any strong evidence against the continued use of these devices.
Nevertheless, the small but statistically significant increases in kidney and prostate cancers and the decrease in gastric cancer deserve further studv. [J Natl Cancer Inst 87 : 28-33.
Mots-clés Pascal : Tumeur maligne, Facteur risque, Epidémiologie, Prothèse, Hanche, Métal, Chirurgie orthopédique, Etude cohorte, Suède, Europe, Homme
Mots-clés Pascal anglais : Malignant tumor, Risk factor, Epidemiology, Prosthesis, Hip, Metal, Orthopedic surgery, Cohort study, Sweden, Europe, Human
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0437280
Code Inist : 002B04B. Création : 01/03/1996.