Higher Blood Cobalt and Chromium Levels in Patients With Unilateral Metal-on-Metal Total Hip Arthroplasties Compared to Hip Resurfacings

The Journal of Arthroplasty
O LainialaAntti Eskelinen

Abstract

Adverse soft tissue reactions in metal-on-metal (MoM) hip replacements are associated with cobalt (Co) and chromium (Cr) ions in blood. We report the prevalence and risk factors for elevated blood Co and Cr levels in patients with a unilateral MoM hip. From a single institution, blood Co and Cr levels were analyzed in 1748 patients (692 hip resurfacings and 1056 total hip arthroplasties [THAs]). Concentrations exceeding 7 ppb were considered elevated, and the risk factors for elevated levels were calculated with binary logistic regression. Elevated blood metal ion levels were more common in MoM THA than in resurfacing patients (17.4% vs 5.9%, P < .001), and in 5 of the 7 THA brands, more than 20% of patients had elevated metal ion concentrations, whereas the proportion was less than 10% in all hip resurfacings. In resurfacings, small femoral head (odds ratio [OR] 1.30 per millimeter decrease [CI, 1.12-1.49]), high acetabular inclination (OR 1.15 per degree increase [CI 1.09-1.22]), and young age (OR 1.05 per year decrease [1.02-1.10]) were independent risk factors for elevated ions. In the THA group, female gender (OR 2.04 [CI 1.35-3.06]), longer time between surgery and ion measurement (OR 1.19 per year increase [CI 1.05-1.34]...Continue Reading

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Citations

Apr 5, 2018·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Anne PostlerJörg Lützner
May 4, 2017·EFORT Open Reviews·Christiaan P van LingenCees C Verheyen
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Feb 22, 2017·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Albrecht HartmannJens Goronzy
Oct 19, 2019·Khirurgiia·V V LubchakM I Shubnyakov

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