Intermediate-term trends in serum levels of metal ions after hip resurfacing arthroplasty

Jiang, Wenxue; Wan, Yanlin; Cui, Peng; Ning, Xianjia

doi:10.1186/s13018-015-0335-0

Cited by 4 publications

(7 citation statements)

References 28 publications

(29 reference statements)

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“…Cobalt and chromium levels were measured according to the method described by Savarino et al 49 and Jiang et al 50 Venous blood samples were collected from the antecubital vein of fasting patients in the morning. Trying to avoid metal contamination during the blood sample collection and analysis was done by discarding the first 5 mL of the collected blood to avoid contamination from the needle, and collecting the samples in metal-free vacutainer tubes.…”

Section: Methodsmentioning

confidence: 99%

Psychiatric Disorders and Genotoxicity Following Primary Metal on Polyethylene Total Hip Arthroplasty and Their Correlation to Cobalt/Chromium Levels

Hamid

Attia

Hirshon

et al. 2022

DHPS

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Introduction Hip arthroplasty (HA) using implantable metal components is among the commonest orthopedic interventions. However, it can be followed by several complications following corrosion and the release of metal ions. Several studies proved that damaged genomic DNA may contribute to the pathophysiology of mental disorders. Aim The current work aims to evaluate the psychiatric disorders in metal on polyethylene hip arthroplasty (MOP-HA) patients and its correlation to cobalt/chromium (Co/Cr) levels and genotoxicity. Methods The work was a longitudinal follow-up study including 34 adults with unilateral primary MOP-HA meeting the inclusion and exclusion criteria. Preoperatively, 6, 12-months-postoperatively, patients were examined for cognitive impairment using mini-mental-state-examination (MMSE), depression using major-depressive-inventory (MDI), and blood samples were collected for estimation of Co/Cr, detection of genotoxicity by single-cell-gel-electrophoresis (comet assay) and serum 8-hydroxy-2’–deoxyguanosine (8-OHdG). Results Cognitive impairment was reported in 18.5% and 14.8% at 6-months, and 12-months postoperative, respectively. Depressive disorder was recorded in 22.2% at 6-months and 14.8% at 12-months postoperative. The marginal homogeneity tests proved a non-significant difference. There was a non-significant difference in preoperative, 6-months, 12-months postoperative MMSE, and MDI scores. There were significantly increased Co/Cr levels at 6-months postoperative. The levels decreased at 12-months postoperative, however, still significantly higher than preoperative values. There was a significant increase in serum 8-OHdG and the levels were positively correlated to cobalt levels at both 6 and 12-months-postoperative. There was a non-significant difference among preoperative, 6-months, and 12-months postoperative comet assay measurements. Conclusion From previous findings, we can conclude that will-functioning MOP hip arthroplasty can induce increased ion levels and positively correlated increase in biochemical markers of genotoxicity (8-OHdG).

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Section: Methodsmentioning

confidence: 99%

Psychiatric Disorders and Genotoxicity Following Primary Metal on Polyethylene Total Hip Arthroplasty and Their Correlation to Cobalt/Chromium Levels

Hamid

Attia

Hirshon

et al. 2022

DHPS

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“…Of those that have, none have identified a significant relationship between BMI and metal ion levels. 9,17 These studies were limited in their analyses because they included either a mixture of HRA and THA implant designs or patients with bilateral implants.…”

Section: Discussionmentioning

confidence: 99%

“…Many previous studies have looked at cohorts with mixed MoM implant designs. 8,9 However, this study narrows the focus by examining the effect of obesity and other covariates on blood metal ion levels and ALTR in the ASR Hip System specifically. Furthermore, we provide data separately on these relationships in both the ASR HRA and ASR XL THA cohorts.…”

Section: Discussionmentioning

confidence: 99%

“…The effect of obesity on the failure of MoM hip resurfacing and THA remains unclear in the literature. Some studies have shown obesity has no association with elevated metal ion levels, 8,9 while others have found high BMI to be associated with failure of MoM hip resurfacing secondary to ALTR. 10,11 The primary aim of this study was to investigate whether obese patients (⩾30 kg/m 2 BMI) were at increased risk of elevated blood metal ion levels if they were treated with the Articular Surface Replacement (ASR) Hip System (DePuy Orthopaedics, Warsaw, IN, USA).…”

Section: Introductionmentioning

confidence: 99%

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Obesity is not associated with hip failure in patients with articular surface replacement of the hip

et al. 2019

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Background: Our main aim was to investigate whether obese patients were at increased risk of elevated metal ion levels and/or adverse local tissue reaction (ALTR) after being treated with articular surface replacement (ASR) hip arthroplasty. Methods: This study included 360 patients who underwent metal-on-metal (MoM) hip resurfacing (HRA) or total hip arthroplasty (THA). 95 patients (26%) were underweight/normal weight (BMI < 25 kg/m2), 139 (39%) were overweight (BMI 25–30 kg/m2), and 126 (36%) were obese (BMI ⩾ 30 kg/m2). Blood metal ion levels and patient-reported outcome measures (PROMs) were obtained, and a sub-cohort of 85 patients had MARS MRI performed. Logistic regression analyses were used to assess the associations between obesity and metal ions, as well as ALTR. Results: BMI was not associated with either elevated metal ion levels or ALTR. In HRA patients, female gender (OR 3.0; p = 0.019) and pain (OR 2.3; p = 0.046) were associated with elevated Co levels. Female patients had increased risk of elevated Cr levels (OR 3.0; p = 0.02). In THA patients, female gender (OR 2.2; p = 0.004) and VAS satisfaction (OR 2.1; p = 0.01) were associated with elevated Co levels. Female gender (OR 3.6; p = 0.001) and time from surgery (OR 1.4; p = 0.005) were associated with Cr levels. In the sub-cohort, ALTR was associated with Co levels (OR 16.1; p = 0.002) in HRA patients. Conclusion: Patients with BMI ⩾ 30 kg/m2 present no increased risk for elevated metal ion levels or development of ALTR.

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“…Hip MoM implants, including MoMHRAs, have also been used to treat bilateral hip arthritis [ 11 – 14 ]. Increased metal ion levels have been correlated in some studies with the development of ARMD and serum metal ion levels are higher in patients with bilateral compared with unilateral MoMHRAs [ 14 – 17 ]. In a previous study, we reported pathological findings in a small series of patients with bilateral MoMHRAs that developed bilateral pseudotumours [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Implant failure in bilateral metal-on-metal hip resurfacing arthroplasties: a clinical and pathological study

Uchihara

Grammatopoulos

Munemoto

et al. 2018

J Mater Sci: Mater Med

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Metal-on-metal hip resurfacing arthroplasties (MoMHRAs) have a high failure rate due to pseudotumour formation. It is not certain whether pseudotumours in bilateral MoMHRAs form on the basis of an adverse reaction to metal debris (ARMD) that is entirely due to a local innate and adaptive immune response to Cobalt-Chrome (Co-Cr) wear particles. To determine if there is a systemic component to ARMD in bilateral MoMHRAs, we examined the histology of ARMD in unilateral and bilateral MoMHRAs revised for pseudotumour and determined whether implant survival differed between these two groups. Periprosthetic tissue specimens from 119 hips revised for pseudotumour were examined. These were derived from 109 patients including 10 patients with bilateral MoMHRAs and 99 with sunilateral MoMHRAs including a cohort of 20 patients with bilateral MoMHRAs that had undergone only one MoMHRA revision for pseudotumour. The mean time to revision for pseudotumour of unilateral and bilateral MoMHRAs was determined. The histology of periprosthetic tissue was examined for evidence of the innate and adaptive immune response and scored semi-quantitatively. There was no significant difference in histological features of the innate / adaptive response between Group 1 bilateral pseudotumours and Group 2 and Group 3 unilateral pseudotumours. Histological features, including ALVAL scores, were similar in the periprosthetic tissues of right and left hips in Group 1 bilateral MoMHRAs. The mean time to first revision for pseudotumour of bilateral MoMHRAs (6.59 years) was not decreased compared with unilateral MoMHRAs (5.66 years) or bilateral MoMHRAs that had only one revision (7.05 years). Right and left hip pseudotumours in bilateral MoMHRAs exhibit similar histological features of the innate and adaptive immune response. Mean implant survival is not decreased in bilateral compared with unilateral MoMHRA cases. The findings suggest that pseudotumour formation is due more to a local than a systemic innate /adaptive immune response to components of metal wear.

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Intermediate-term trends in serum levels of metal ions after hip resurfacing arthroplasty

Cited by 4 publications

References 28 publications

Psychiatric Disorders and Genotoxicity Following Primary Metal on Polyethylene Total Hip Arthroplasty and Their Correlation to Cobalt/Chromium Levels

Psychiatric Disorders and Genotoxicity Following Primary Metal on Polyethylene Total Hip Arthroplasty and Their Correlation to Cobalt/Chromium Levels

Obesity is not associated with hip failure in patients with articular surface replacement of the hip

Implant failure in bilateral metal-on-metal hip resurfacing arthroplasties: a clinical and pathological study

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