Serum Metal Levels for Diagnosis of Adverse Local Tissue Reactions Secondary to Corrosion in Metal-on-Polyethylene Total Hip Arthroplasty

The Journal of Arthroplasty
Yale A FillinghamJoshua J Jacobs

Abstract

Recently, corrosion at the head-neck junction in metal-on-polyethylene bearing surface total hip arthroplasty (THA) has been recognized as a cause of adverse local tissue reactions (ALTRs). Serum metal levels have been advocated as a tool for the diagnosis of ALTR; however, no prior studies have specifically examined their utility. The purpose of this study was to determine the optimal cutoff values for serum cobalt and chromium levels in diagnosing ALTR after metal-on-polyethylene bearing surface THA. We reviewed 447 consecutive patients with serum metal levels tested at our institution and identified 64 patients with a metal-on-polyethylene bearing who had axial imaging or underwent reoperation to confirm the presence or absence of ALTR. Receiver-operating characteristic curves were produced to identify cutoff thresholds to optimize sensitivity, and diagnostic test performance was characterized. Forty-four of the 64 patients (69%) were positive for an ALTR. The best test for the diagnosis of ALTR was the serum cobalt level (area under the curve [AUC] = 99%). A threshold cutoff of ≥1.0 ng/mL had a sensitivity of 100%, specificity of 90%, positive predictive value (PPV) of 96%, and negative predictive value (NPV) of 100%. Serum...Continue Reading

Citations

Sep 21, 2018·The Journal of Bone and Joint Surgery. American Volume·Mengnai Li, Andrew H Glassman
Aug 20, 2019·Journal of Biomedical Materials Research. Part B, Applied Biomaterials·Qiong WangRizhi Wang
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Aug 11, 2020·The Journal of Bone and Joint Surgery. American Volume·Mengnai Li, Andrew H Glassman
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