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Concentration urinaire du cobalt et du chrome chez les patients porteurs d'une prothèse totale de hanche non cimentée

The concentration of cobalt and chromium in the urine of patients with uncemented total replacement of the hip

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Summary

The concentrations of cobalt and chromium have been measured in the urine of 22 patients who had received uncemented hip prostheses made from cobalt, chromium and molybdenum alloy, and in 21 patients who had not received prostheses, using absorption spectrophotometry. The results were statistically analysed using the Wilcoxon test.

The levels of cobalt in the urine in the patients with uncemented prostheses did not show a significant increase, indicating that there is no greater risk of cobalt toxicity.

The concentration of chromium was significantly raised (p<10−2 in the urine of patients with uncemented prostheses, and in three of these patients significant corrosion had occurred.

Résumé

Le relargage du Cobalt et du Chrome issus d'une prothèse totale de hanche non cimentée en alliage de Cobalt, Chrome et Molybdène est évalué par dosages urinaires faisant appel à la spectrophotométrie d'absorption atomique, en comparant un groupe de 22 patients porteurs de cet implant et un groupe de 21 sujets témoins. Les résultats sont soumis à l'analyse statistique (test de Wilcoxon):

  • -Il n'existe pas d'élévation significative de la concentration urinaire de Cobalt chez les patients porteurs d'une prothèse non cimentée. Les risques de nécrose osseuse ou d'une éventuelle carcinogénèse, liés, à la diffusion de cet ion, semblent donc négligeables.

  • -L'élévation significative (p<10−2) du taux de Chrome urinaire dans ce même groupe est liée à des phénomènes de corrosion plus prononcés apparus chez trois patients.

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Authors and Affiliations

  1. Clinique de Traumatologie et d'Orthopédie, 49, rue Hermite, F-54000, Nancy, France

    E. Braun, D. Schmitt, H. Coudane & D. Molé

  2. Laboratoire de biochimie, CHU Nancy-Brabois, F-54500, Vandoeuvre, France

    F. Nabet

  3. Laboratoire d'informatique médicale, Faculté de Médecine de Nancy, Avenue de la Forêt de Haye, F-54500, Vandoeuvre, France

    B. Legras

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  1. E. Braun
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Braun, E., Schmitt, D., Nabet, F. et al. Concentration urinaire du cobalt et du chrome chez les patients porteurs d'une prothèse totale de hanche non cimentée. International Orthopaedics 10, 277–282 (1986). https://doi.org/10.1007/BF00454409

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