Elevation of Serum Cobalt and Chromium Levels in Patients With Metal-On-Metal Resurfacing Hip Prostheses: A 3-Year Follow-up

2007 ◽  
Vol 22 (2) ◽  
pp. 311 ◽  
Author(s):  
D. Gordon Allan ◽  
B. Parsley ◽  
Brad Dyrstad ◽  
Rita Trammell ◽  
Joseph C. Milbrandt
Keyword(s):  
Hip Prostheses ◽  
Metal On Metal ◽  
Serum Cobalt

Safe Upper Limits of Serum Cobalt and Chromium Levels for the M2a-Magnum Metal-on-Metal Total Hip Bearing: A 10-Year Follow-Up Study

2021 ◽  
Author(s):  
Maarten C. Koper ◽  
Brechtje Hesseling ◽  
Wim E. Tuinebreijer ◽  
Hans van der Linden ◽  
Nina M.C. Mathijssen
Keyword(s):  
Total Hip ◽  
Follow Up Study ◽  
Metal On Metal ◽  
Upper Limits ◽  
Serum Cobalt

scholarly journals Pseudotumours, cobalt and clinical outcome in small head metal-on-metal versus conventional metal-on-polyethylene total hip arthroplasty

2019 ◽  
Vol 30 (1) ◽  
pp. 56-63
Author(s):  
Hugo C van der Veen ◽  
Inge HF Reininga ◽  
Wierd P Zijlstra ◽  
Martijn F Boomsma ◽  
Sjoerd K Bulstra ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Follow Up Study ◽  
Metal On Metal ◽  
Small Head ◽  
Long Term Follow Up ◽  
Serum Cobalt

Background: Metal-on-metal total hip arthroplasty (MoM THA) is associated with the formation of pseudotumours. Studies mainly concern pseudotumour formation in large head MoM THA. We performed a long-term follow-up study, comparing pseudotumour incidence in small head metal-on-metal (SHMoM) THA with conventional metal-on-polyethylene (MoP) THA. Predisposing factors to pseudotumour formation were assessed. Methods: From a previous randomised controlled trial comparing SHMoM (28 mm) cemented THA with conventional MoP cemented THA, patients were screened using a standardised CT protocol for the presence of pseudotumours. Serum cobalt levels and functional outcome were assessed. Results: 56 patients (33 MoP and 23 MoM) were recruited after mean follow-up of 13.4 years (SD 0.5). The incidence of pseudotumours was 1 (5%) in the SHMoM THA cohort and 3 (9%) in the MoP THA cohort. Prosthesis survival was 96% for both SHMoM and MoP THAs. Serum cobalt levels did not exceed acceptable clinical values (<5 µg/L) whereas no differences in cobalt levels were detected at follow-up between both groups. Oxford and Harris Hip Scores were good and did not differ between SHMoM and MoP THA. Conclusions: This long-term follow-up study shows a low incidence of pseudotumour formation and good functional outcome in cemented head-taper matched SHMoM and MoP THA.

scholarly journals Auditory and Visual Health after Ten Years of Exposure to Metal-on-Metal Hip Prostheses: A Cross-Sectional Study Follow Up

PLoS ONE ◽  
2014 ◽  
Vol 9 (3) ◽  
pp. e90838 ◽  
Author(s):  
Jennifer R. Prentice ◽  
Christopher S. Blackwell ◽  
Naz Raoof ◽  
Paul Bacon ◽  
Jaydip Ray ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hip Prostheses ◽  
Metal On Metal ◽  
Visual Health

scholarly journals Serum cobalt concentrations remain at low levels at a minimum of 20 years following metal-on-metal total hip arthroplasty

2020 ◽  
Vol 9 (3) ◽  
pp. 146-151 ◽  
Author(s):  
Wenzel Waldstein ◽  
Ulrich Koller ◽  
Bernhard Springer ◽  
Paul Kolbitsch ◽  
Wolfram Brodner ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Controlled Study ◽  
Control Group ◽  
Total Hip ◽  
Metal On Metal ◽  
Low Levels ◽  
Serum Cobalt

Aims Second-generation metal-on-metal (MoM) articulations in total hip arthroplasty (THA) were introduced in order to reduce wear-related complications. The current study reports on the serum cobalt levels and the clinical outcome at a minimum of 20 years following THA with a MoM (Metasul) or a ceramic-on-polyethylene (CoP) bearing. Methods The present study provides an update of a previously published prospective randomized controlled study, evaluating the serum cobalt levels of a consecutive cohort of 100 patients following THA with a MoM or a CoP articulation. A total of 31 patients were available for clinical and radiological follow-up examination. After exclusion of 11 patients because of other cobalt-containing implants, 20 patients (MoM (n = 11); CoP (n = 9)) with a mean age of 69 years (42 to 97) were analyzed. Serum cobalt levels were compared to serum cobalt levels five years out of surgery. Results The median cobalt concentration in the MoM group was 1.04 μg/l (interquartile range (IQR) 0.64 to 1.70) at a mean of 21 years (20 to 24) postoperatively and these values were similar (p = 0.799) to cobalt levels at five years. In the CoP control group, the median cobalt levels were below the detection limit (< 0.3 μg/l; median 0.15 μg/l, IQR 0.15 to 0.75) at 20 years. The mean Harris Hip Score was 91.4 points (61 to 100) in the MoM group and 92.8 points (63 to 100) in the CoP group. Conclusion This study represents the longest follow-up series evaluating the serum cobalt levels after 28 mm head MoM bearing THA and shows that serum cobalt concentrations remain at low levels at a mean of 21 years (20 to 24) after implantation. Cite this article: Bone Joint Res. 2020;9(3):145–150.

scholarly journals Whole blood chromium concentration is very rarely elevated independently of whole blood cobalt

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Olli Lainiala ◽  
Mari Karsikas ◽  
Aleksi Reito ◽  
Antti Eskelinen
Keyword(s):  
Whole Blood ◽  
Cost Savings ◽  
Chromium Concentration ◽  
Continuous Variables ◽  
Metal Debris ◽  
Screening Guidelines ◽  
Metal On Metal ◽  
Hip Replacements

AbstractDue to the risk of adverse reactions to metal debris resulting from increased wear of the arthroplasty more than one million metal-on-metal (MoM) hip replacements worldwide are in active follow-up. Follow-up usually includes measurement of both whole blood cobalt (Co) and chromium (Cr) concentrations. Our experience is that Cr is seldom independently elevated. We wanted to ascertain whether blood Cr measurements could be omitted from follow-up protocols without lowering the quality of follow-up. We identified 8438 whole blood Co and Cr measurements performed without or prior to revision surgery. When the cut-off levels 5 µg/L and 7 µg/L were used, Cr was independently elevated in only 0.5% (95% confidence interval, CI, 0.3 to 0.6) and 0.2% (CI 0.1 to 0.3) of the measurements. The models with continuous variables showed that the higher the blood metal concentrations are the lower the percentage of measurements with Cr higher than Co. Our results suggest that whole blood Cr is very rarely independently elevated and therefore the authorities should consider omitting Cr measurements from their screening guidelines of MoM hip replacements. We believe this change in practice would simplify follow-up and lead to cost savings without decreasing the quality of follow-up.

scholarly journals Uncemented versus cemented arthroplasty after metal-on-metal total hip replacement in patients with femoral neck fractures: a retrospective study

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110122
Author(s):  
Wenlu Liu ◽  
Huanyi Lin ◽  
Xianshang Zeng ◽  
Meiji Chen ◽  
Weiwei Tang ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Clinical Outcomes ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Neck Fractures ◽  
Harris Hip Score ◽  
Complication Rates ◽  
Total Hip ◽  
Metal On Metal

Objective To compare the clinical outcomes of primary metal-on-metal total hip replacement (MoM-TR) converted to uncemented total hip replacement (UTR) or cemented total hip replacement (CTR) in patients with femoral neck fractures (AO/OTA: 31B/C). Methods Patient data of 234 UTR or CTR revisions after primary MoM-TR failure from March 2007 to January 2018 were retrospectively identified. Clinical outcomes, including the Harris hip score (HHS) and key orthopaedic complications, were collected at 3, 6, and 12 months following conversion and every 12 months thereafter. Results The mean follow-up was 84.12 (67–100) months for UTR and 84.23 (66–101) months for CTR. At the last follow-up, the HHS was better in the CTR- than UTR-treated patients. Noteworthy dissimilarities were correspondingly detected in the key orthopaedic complication rates (16.1% for CTR vs. 47.4% for UTR). Statistically significant differences in specific orthopaedic complications were also detected in the re-revision rate (10.3% for UTR vs. 2.5% for CTR), prosthesis loosening rate (16.3% for UTR vs. 5.9% for CTR), and periprosthetic fracture rate (12.0% for UTR vs. 4.2% for CTR). Conclusion In the setting of revision of failed primary MoM-TR, CTR may demonstrate advantages over UTR in improving functional outcomes and reducing key orthopaedic complications.

scholarly journals Small-head metal on metal total hip arthroplasty is associated with a high rate of complication and reoperation at mid-term follow-up

2021 ◽  
Vol 9 ◽  
pp. 205031212110147
Author(s):  
Nobuhiko Sumiyoshi ◽  
Kazuhiro Oinuma ◽  
Yoko Miura
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Adverse Reactions ◽  
Small Diameter ◽  
High Rate ◽  
Metal Debris ◽  
Total Hip ◽  
Metal On Metal ◽  
Small Head

Background: Adverse reactions to metal debris are significant complications after metal-on-metal total hip arthroplasty. Recently, late appearances of adverse reactions to metal debris and subsequent need for reoperations have been reported with small-diameter head metal-on-metal devices. We retrospectively investigated mid-term clinical outcomes of small-head metal-on-metal total hip arthroplasty. Methods: We reviewed 159 hips in 139 patients who had a small-head metal-on-metal total hip arthroplasty (M2a Taper; Biomet, Warsaw, IN) with a minimum 5-year follow-up and documented postoperative complications. Results: Focal osteolysis in either the femur or acetabulum was observed in 12 hips (7.5%, 44 months after surgery on average), with pseudotumor observed in 8 hips (5%, 120 months after surgery on average). Four hips (2.5%) had dislocations (84 months after surgery on average) and six hips (3.8%, 122 months after surgery on average) underwent reoperation. Conclusion: Small-head metal-on-metal total hip arthroplasty is associated with a high degree of complications at mid-term follow-up period. Considering this, we discourage the use of metal-on-metal total hip arthroplasty regardless of head size.

Imaging of Metal-on-Metal Hip Prostheses

2011 ◽  
Vol 197 (3) ◽  
pp. 556-557 ◽  
Author(s):  
Matthew W. Squire
Keyword(s):  
Hip Prostheses ◽  
Metal On Metal
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