Blood metal ion concentrations in metal-on-metal total hip arthroplasty

Ohtsuru, Tadahiko; Morita, Yuji; Murata, Yoshinori; Shimamoto, Shuji; Munakata, Yutaro; Kato, Yoshiharu

doi:10.1007/s00590-017-1931-y

Cited by 6 publications

(5 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our series, Co level and Co/Cr ratio were significantly higher in THA compared to RHA. These findings suggest an additional source of ion production in THA other than the head-cup bearing interface [ 4 , 38 , 39 ]. A similar result was described by Ridon et al and Johnson et al in series comparing RHA and THA constructs performed with the same acetabular component [ 15 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

“…MoM bearing surfaces were postulated at that time to decrease the risk of aseptic loosening related to wear and therefore to increase implant survivorship compared to conventional metal or ceramic on polyethylene bearings [1]. However, several reports in the literature raised safety concerns about MoM bearing due to increased chromium (Cr) and cobalt (Co) blood ion concentrations [2][3][4][5], adverse reaction to metal debris (ARMD) [6][7][8], osteolysis [9], and implant loosening [10][11][12][13], leading to restriction of use imposed by regulatory agencies worldwide. To date, the outcome of MoM THA is known to be poorer than conventional bearings with complication rates as high as 15.5% at ten years [14,15].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of the long-term cause of failure and survivorship of four hundred and twenty seven metal-on-metal hip arthroplasties: resurfacing versus large head total hip arthroplasty

Palazzuolo

Antoniadis

Delaune

et al. 2021

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Introduction Comparison of mid- to long-term cause of failure and survivorship of metal-on-metal (MoM) resurfacing hip arthroplasty (RHA) and large head total hip arthroplasty (THA) remains sparse. This study aimed to identify and compare the cause of failure and survivorship of MoM RHA and THA at a minimum ten year follow-up. Methods Four hundred twenty-seven MoM hip arthroplasties (286 THA and 141 RHA) were retrospectively analyzed at a mean follow-up of 13 ± three years. Causes of failure were reported as MoM specific (i.e., adverse reaction to metal debris (ARMD) and painful hip with ion elevation) or MoM non-specific (i.e., fracture, infection, and dislocation). Chromium (Cr) and cobalt (Co) ion levels and Co/Cr ratio were compared. Survivorship was compared according to the cause of failure with revision as the endpoint. Results The rate of ARMD was significantly higher in THA (OR = 2.9 [95%-CI: 1–7]; p = 0.02). No significant difference was detected in failure rate due to other causes between the two groups (p = 0.2–0.9). Ion levels and Co/Cr ratio were both significantly higher in THA (p < 0.01). Survivorship was significantly lower in THA compared to RHA at ten years [89% (95%-CI: 85%–91%) vs 96% (95%-CI: 91%–98%); p = 0.01] and 15 years [73% (95%-CI: 67%–78%) vs 83% (95%-CI: 73%–90%); p = 0.01]. Conclusion RHA survivorship was significantly higher at any time point. Failure rate due to ARMD was significantly higher in THA while no significant difference in other causes of failure was observed between the two groups. This result emphasizes the role of fretting corrosion at the head-neck junction (i.e., trunnionosis) with significantly higher ion levels and Co/Cr ratio dissociation in THA.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of the long-term cause of failure and survivorship of four hundred and twenty seven metal-on-metal hip arthroplasties: resurfacing versus large head total hip arthroplasty

Palazzuolo

Antoniadis

Delaune

et al. 2021

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…[128][129][130] Strong evidence indicated high average Co concentrations in the urine of patients who had undergone THA. 81,92,[131][132][133][134][135][136][137][138][139] An experiment administering Co intravenously in humans demonstrated that 40% was eliminated within the first 24 hours, 70% within a week, 80% within a month, and 90% within a year. 140 The geometric mean Mo level in the blood was 15.36 nmol/L, while the highest level in urine was 58.41 μmol/L.…”

Section: Excretion and Eliminationmentioning

confidence: 99%

Prosthetic Metals: Release, Metabolism and Toxicity

Zhong,

Pan,

Chen

et al. 2024

IJN

View full text Add to dashboard Cite

The development of metallic joint prostheses has been ongoing for more than a century alongside advancements in hip and knee arthroplasty. Among the materials utilized, the Cobalt-Chromium-Molybdenum (Co-Cr-Mo) and Titanium-Aluminum-Vanadium (Ti-Al-V) alloys are predominant in joint prosthesis construction, predominantly due to their commendable biocompatibility, mechanical strength, and corrosion resistance. Nonetheless, over time, the physical wear, electrochemical corrosion, and inflammation induced by these alloys that occur post-implantation can cause the release of various metallic components. The released metals can then flow and metabolize in vivo, subsequently causing potential local or systemic harm. This review first details joint prosthesis development and acknowledges the release of prosthetic metals. Second, we outline the metallic concentration, biodistribution, and elimination pathways of the released prosthetic metals. Lastly, we discuss the possible organ, cellular, critical biomolecules, and significant signaling pathway toxicities and adverse effects that arise from exposure to these metals.

show abstract

“…Biochemical molecules, such as Ca 2+ , Mg 2+ , Zn 2+ , vitamin D (VD), and parathyroid hormone (PTH), are crucial components of bone marrow microenvironment, which may in uence the bone marrow osseointegration and the outcome of THA [6]. In addition, human bone marrow cells contain two populations of bone marrow stem cells: mesenchymal stem cells (MSCs also called bone marrow stromal cells) and hematopoietic stem cells (HSCs).…”

Section: Introductionmentioning

confidence: 99%

The Local Concentration of Ca2+ Correlates with BMP7 Expression and Osseointegration in Patients with Total Hip Arthroplasty

Wang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background A successful osseointegration of total hip arthroplasty (THA) relies on the interplay of implant surface and bone marrow microenvironment. This study was undertaken to investigate the impact of perioperative biochemical molecules (Ca 2+ , Mg 2+ , Zn 2+ , VD, PTH) on the bone marrow osteogenetic factors (BMP2, BMP7, Stro-1 + cells) in the metaphyseal region of the femoral head, and further on the bone mineral density (BMD) of Gruen R3. Methods Bone marrow aspirates were obtained from the discarded metaphysis region of the femoral head in 51 patients with THA. Flow cytometry was used to measure the Stro-1 + expressing cells. ELISA was used to measure the concentrations of bone morphologic proteins (BMP2 and BMP7). The perioperative concentrations of the biochemical molecules above were measured by radioimmunoassay. The BMD of Gruen zone R3 was examined at 6 months after THA, using dual-energy X-ray absorptiometry (DEXA). Results Our data demonstrated that the concentration of Ca 2+ was positively correlated with BMP7 expression, and with the postoperative BMD of Gruen zone R3. However, the concentration of Mg 2+ had little impact on the R3 BMD, although it was negatively correlated with the expression of BMP7. The data also suggested that the other biochemical molecules, such as Zn 2+ , VD, and PTH, were not significantly correlated with any bone marrow osteogenetic factors (BMP2, BMP7, Stro-1 + cells). The postoperative R3 BMD of patients of different gender and age had no significant difference. Conclusions These results indicate the local concentration of Ca 2+ may be an indicator for the prognosis of THA patients.

show abstract

Blood metal ion concentrations in metal-on-metal total hip arthroplasty

Abstract: We considered that cup version angle is one of the factors that have the greatest effect on blood metal ion concentration, and the target cup version angle that did not induce an increase in blood metal ion concentrations was approximately 20°.

Cited by 6 publications

References 18 publications

Comparison of the long-term cause of failure and survivorship of four hundred and twenty seven metal-on-metal hip arthroplasties: resurfacing versus large head total hip arthroplasty

Comparison of the long-term cause of failure and survivorship of four hundred and twenty seven metal-on-metal hip arthroplasties: resurfacing versus large head total hip arthroplasty

Prosthetic Metals: Release, Metabolism and Toxicity

The Local Concentration of Ca2+ Correlates with BMP7 Expression and Osseointegration in Patients with Total Hip Arthroplasty

Contact Info

Product

Resources

About