Clinical Results and Serum Metal Ion Concentrations following Ceramic-on-Metal Total Hip Arthroplasty at a Mean Follow-Up of 60 Months

• Published in: BioMed research international Vol. 2017; no. 2017; pp. 1 - 6
• Main Authors: Leithner, Andreas, Holzer, Lukas A., Bratschitsch, G., Friesenbichler, Joerg, Pranckh-Matzke, D., Maurer-Ertl, Werner, Maier, M.
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Publishing Corporation 01.01.2017; Hindawi; John Wiley & Sons, Inc; Hindawi Limited
• Subjects: Adult; Aged; Aged, 80 and over; Arthritis; Arthroplasty, Replacement, Hip - adverse effects; Bone Anteversion - blood; Bone Anteversion - chemically induced; Bone Anteversion - pathology; Ceramics - adverse effects; Ceramics - therapeutic use; Chromium - adverse effects; Chromium - blood; Chromium - therapeutic use; Cobalt - adverse effects; Cobalt - blood; Cobalt - therapeutic use; Female; Follow-Up Studies; Hip Prosthesis - adverse effects; Humans; Ions; Ions - adverse effects; Ions - blood; Ions - therapeutic use; Joint surgery; Male; Metal ions; Metals; Middle Aged; Orthopedic implants; Patient outcomes; Physiological aspects; Prosthesis Design; United States > US
• ISSN: 2314-6133; 2314-6141
• DOI: 10.1155/2017/3726029

Background. Increased metal ion levels following total hip arthroplasty (THA) with metal-on-metal bearings are a highly debated topic. Local soft tissue reactions with chronic pain and systemic side effects such as neuropathy are described. The aim of the current study was to determine the serum metal ion concentrations of Cobalt (Co) and Chrome (Cr) after THA with a ceramic-on-metal (CoM) bearing. Patients and Methods. Between 2008 and 2010, 20 patients underwent THA using a CoM bearing. Clinical function was evaluated by standardized scores systems (Harris Hip Score and WOMAC Score) and radiological examination included X-rays. Patient’s blood samples were obtained for metal ion analysis and correlation analysis was done between these results and implant position. Results. Overall, 13 patients with 14 CoM devices were available for the current series. The mean age at time of surgery was 61 years (range, 41 to 85). The postoperative follow-up ranged from 49 to 68 months (mean, 58). Metal ion determination showed mean concentrations of 3,1 µg/L (range, 0,3–15,2 µg/L) for Co and 1,6 µg/L (range, 0,1–5,5 µg/L) for Cr, respectively. A correlation between cup anteversion and Co and Cr concentrations was shown. Conclusion. The current series showed increments for Co and Cr following CoM THA. However, these levels are lower compared to metal ion concentrations in patients with metal-on-metal bearings and the international accepted threshold for revision of MoM devices. We recommend routine follow-up including at least one obligatory evaluation of serum metal ion concentrations and an MRI once to exclude local soft tissue reactions.