Top

Archives of Orthopaedic and Trauma Surgery

Published in:

01-12-2010 | Orthopaedic Surgery

Serum metal ion levels after second-generation metal-on-metal total hip arthroplasty

Authors: Takao Imanishi, Masahiro Hasegawa, Akihiro Sudo

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 12/2010

Abstract

Introduction

Metal-on-metal bearings for total hip arthroplasty are increasing in popularity. However, metal ion toxicity, metal hypersensitivity, and metal carcinogenicity are the causes concern for patients with metal-on-metal hip replacement. We investigated serum levels of cobalt and chromium ions in patients with successfully implanted second-generation metal-on-metal total hip arthroplasty (THA) using PINNACLE-A (DePuy, Warsaw, IN, USA).

Materials and methods

Thirty-three patients underwent primary cementless THA with the use of a 36-mm femoral head PINNACLE-A with a metal-on-metal articulation. Blood samples were taken preoperatively, at 3 months, and at 1 year, and levels of cobalt and chromium were determined.

Results

At 3 months, levels of both cobalt and chromium had increased significantly compared with preoperative levels. There were no significant differences between levels of either metal at 3 months and 1 year.

Conclusion

Patients with metal-on-metal THA had higher circulating levels of metal ions than before arthroplasty at 3 months, with no additional significant increases at 1 year in this study.

Cobb AG, Schmalzreid TP (2006) The clinical significance of metal ion release from cobalt–chromium metal-on-metal hip joint arthroplasty. Proc Inst Mech Eng 220:385–398

Visuri TI, Pukkala E, Pulkkinen P, Paavolainen P (2006) Cancer incidence and causes of death among total hip replacement patients: a review based on Nordic cohorts with a special emphasis on metal-on-metal bearings. Proc Inst Mech Eng 220:399–407

Engh CA, Hopper RH Jr, Engh CA Jr (2004) Long-term porous-coated cup survivorship using spikes, screws, and press-fitting for initial fixation. J Arthroplasty 19(7 Suppl 2):54–60CrossRefPubMed

Powers CC, Ho H, Beykirch SE, Huynh C, Hopper RH Jr, Engh CA Jr, Engh CA (2009) A comparison of a second- and a third-generation modular cup design is new improved? J Arthroplasty. April 8. [Epub ahead of print]

Ohashi H, Hirohashi K, Yamano Y (2000) Factors influencing the outcome of Chiari pelvic osteotomy: a long-term follow-up. J Bone Joint Surg Br B 82-B:517–525CrossRef

Antoniou J, Zukor DJ, Mwale F, Minarik W, Petit A, Huk OL (2008) Metal ion levels in the blood of patients after hip resurfacing: A comparison between twenty-eight and thirty-six-millimeter-head metal-on-metal prostheses. J Bone Joint Surg Am A 90(Suppl 3):142–148CrossRef

Williams S, Schepers A, Isaac G, Hardaker C, Ingham E, van der Jagt D, Breckon A, Fisher J (2007) Ceramic-on-metal hip arthroplasties: a comparative in vitro and in vivo study. Clin Orthop Relat Res 465:23–32PubMed

Isaac GH, Brockett C, Breckon A, van der Jagt D, Williams S, Hardaker C, Fisher J, Schepers A (2009) Ceramic-on-metal bearings in total hip replacement: whole blood metal ion levels and analysis of retrieved components. J Bone Joint Surg Br 91(9):1134–1141CrossRefPubMed

Savarino L, Granchi D, Ciapetti G, Cenni E, Nardi Pantoli A, Rotini R, Veronesi CA, Baldini N, Giunti A (2002) Ion release in patients with metal-on-metal hip bearings in total joint replacement:a comparison with metal-on-polyethylene bearings. J Biomed Mater Res 63:467–474CrossRefPubMed

10.

Clarke MT, Lee PTH, Arora A, Villar RN (2003) Levels of metal ions after small- and large-diameter metal-on-metal hip arthroplasty. J Bone Joint Surg Br B 85:913–917

11.

Witzleb W, Ziegler J, Krummenauer F, Neumeister V, Guenther K (2006) Exposure to chromium, cobalt and molybdenum from metal-on-metal total hip replacement and hip resurfacing arthroplasty. Acta Orthop 77:697–705CrossRefPubMed

12.

Moroni A, Savarino L, Cadossi M, Baldini N, Giannini S (2008) Does ion release differ between hip resurfacing and metal-on-metal THA? Clin Orthop Relat Res 466:700–707CrossRefPubMed

13.

Brodner W, Bitzan P, Meisinger V, Kaider A, Gottsauner-Wolf F, Kotz R (2003) Serum cobalt levels after metal-on-metal total hip arthroplasty. J Bone Joint Surg Am A 85:2168–2173

14.

Hur CI, Yoon TR, Cho SG, Song EK, Seon JK (2008) Serum ion level after metal-on-metal THA in patients with renal failure. Clin Orthop Relat Res 466:696–699CrossRefPubMed

15.

Zeh A, Becker C, Planert M, Lattke P, Wohlrab D (2009) Time-dependent release of cobalt and chromium ions into the serum following implantation of the metal-on-metal Maverick type artificial lumbar disc (Medtronic Sofamor Danek). Arch Orthop Trauma Surg 129(6):741–746CrossRefPubMed

16.

Vendittoli PA, Mottard S, Roy AG, Dupont C, Lavigne M (2007) Chromium and cobalt ion release following the Durom high carbon content, forged metal-on-metal surface replacement of the hip. J Bone Joint Surg Br B 89:441–448CrossRef

17.

Haan RD, Pattyn C, Gill HS, Murray DW, Campbell PA, Smet KD (2008) Correlation between inclination of the acetabular component and metal ion levels in metal-on-metal hip resurfacing replacement. J Bone Joint Surg Br B 90:1291–1297CrossRef

18.

Langton DJ, Jameson SS, Joyce TJ, Webb J, Nargol AV (2008) The effect of component size and orientation on the concentrations of metal ions after resurfacing arthroplasty of the hip. J Bone Joint Surg Br B 90:1143–1151CrossRef

19.

Heisel C, Silva M, Skipor AK, Jacobs JJ, Schmalzried TP (2005) The relationship between activity and ions in patients with metal-on-metal bearing hip prostheses. J Bone Joint Surg Am A 87:781–787CrossRef

20.

Kahn M, Kuiper JH, Richardson JB (2008) The exercise-related rise in plasma cobalt levels after metal-on-metal hip resurfacing arthroplasty. J Bone Joint Surg Br B 90:1152–1157CrossRef

21.

Ladon D, Doherty A, Newson R, Turner J, Bhamra M, Case CP (2004) Changes in metal levels and chromosome aberrations in the peripheral blood of patients after metal-on-metal hip arthroplasty. J Arthroplasty 19(8 Suppl 3):78–83CrossRefPubMed

22.

Dunstan E, Ladon D, Whittingham-Jones P, Carrington R, Briggs TW (2008) Chromosomal aberrations in the peripheral blood of patients with metal-on-metal hip bearings. J Bone Joint Surg Am A 90:517–522CrossRef

Title: Serum metal ion levels after second-generation metal-on-metal total hip arthroplasty
Authors: Takao Imanishi
Masahiro Hasegawa
Akihiro Sudo
Publication date: 01-12-2010
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 12/2010
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-010-1056-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Serum metal ion levels after second-generation metal-on-metal total hip arthroplasty

Abstract

Introduction

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 12/2010

Necrotizing fasciitis of the extremities: 34 cases at a single centre over the past 5 years

Initial increased wear debris of XLPE-Al2O3 bearing in total hip arthroplasties

Do locking plates have a role in orthopaedic oncological reconstruction

Femoral neck resorption following hybrid metal-on-metal hip resurfacing arthroplasty: a radiological and biomechanical analysis

RETRACTED ARTICLE: Outcomes of length-stable fixation of femoral neck fractures

Rare complication after VAC-therapy in the treatment of deep sore ulcers in a paraplegic patient