Blood Chromium-Cobalt Levels in Patients After Total Knee Arthroplasty and Their Effect on the Retinal Nerve Fiber Layer and Macular Ganglion Cell Complex

Abstract

Purpose: To study blood cobalt (Co) and chromium (Cr) levels in patients who have undergone total knee arthroplasty and their effect on the retinal nerve fiber layer and macular ganglion cell complex. Methods: One hundred patients who had undergone total knee arthroplasty and 50 healthy individuals who had no implants were included in the study. The patients were separated into two groups based on how long ago the prosthesis had been implanted (Group 1: 1 to 5 years; Group 2: 5 to 10 years). After a complete ophthalmological examination, retinal nerve fiber layer and macular ganglion cell complex of the patients were evaluated with optical coherence tomography, performed on dilated pupils. To assess the metal ion levels of the patients, venous blood samples were drawn from each patient. Results: The mean age of the patients was 64.72 ± 6.26 years in Group 1, 67.80 ± 8.07 years in Group 2, and 63.42 ± 7.90 years in the control group. In the comparison of age and sex, there were no statistically significant differences between the groups and the control group. Co and Cr levels were statistically higher in Group 1 and Group 2 compared with the control group (P < 0.001). Mean retinal nerve fiber layer thicknesses and mean macular ganglion cell complex thicknesses in Group 1 and Group 2 were statistically lower than in the control group. Conclusion: Levels of Co and Cr are higher in patients who undergone total knee arthroplasty than healthy subjects, and these higher levels were associated with changes in the retinal nerve fiber layer and macular ganglion cell complex.

A new improvement: subperiosteal cocktail application to effectively reduce pain and blood loss after total knee arthroplasty

“…There was no significant difference in anemic rate before surgery, and only one patient in the periarticular cocktail injection group received blood transfusion after surgery; also, the rates of wound infection and DVT were not increased in the subperiosteal cocktail injection group, which meant that this technique could reduce blood loss without increasing complications [33,34]. Otherwise, the reduced blood loss would also be helpful to decrease the prosthesis loosening rate [35][36][37].…”

Clinical effects of staged joint replacement in patients with septic arthritic knee

“…Inadequately, previously reported staged operations have completed a large amount of osteotomy during the first stage of surgery, which is not conducive to the preservation of bone mass, and if the spacer is left in the body for a long period of time, there is a risk of its loosening or fragmentation, followed by the abrasion of bone mass. Studies have shown that long intervals can cause biofilm formation on the surface of the spacer and further cause continuous infection or reinfection [23][24][25][26]. Therefore, this study proposes the optimization with antibiotic cement beads and tibial plateau spacers.…”

Retrieval Analysis of Modern Knee Tumor Megaendoprosthesis Shows Considerable Volumetric Metal Wear Generated at the Rotating Hinge

“…Considerable levels of metal ions are released during cyclic wear simulation [20]. Clinically, this leads to elevated metal ion levels in the patient's blood [21][22][23]. In addition, the released metal ions accumulate in tissue surrounding the joint, and can lead to adverse local tissue reactions like metallosis [19,24].…”