Serum Metal Ion Exposure after Total Knee Arthroplasty

Abstract

All metal implants release metal ions because of corrosion. This has been studied and debated, especially in metal-on-metal total hip arthroplasties. Total knee arthroplasty implants have large metal surface areas and therefore substantial potential for corrosion. We determined changes in serum levels of metal ions in 41 patients after cemented unconstrained total knee arthroplasty without patellar resurfacing, 18 with unilateral total knee arthroplasty (median, 66 months after surgery) and 23 patients with bilateral total knee arthroplasties (75 and 50 months after first and second surgeries, respectively). Serum concentrations of chromium, cobalt, and molybdenum were analyzed and related to the number of total knee arthroplasties and compared with those of 130 control patients without implants. The median chromium, cobalt, and molybdenum concentrations were 0.92, 3.28, and 2.55 microg/L, respectively, in the unilateral total knee arthroplasty sample and 0.98, 4.28, and 2.40 microg/L, respectively, in the bilateral total knee arthroplasty sample. We observed no difference between the serum levels in patients with unilateral and bilateral arthroplasties, but the serum levels of chromium and cobalt of both study groups were greater than those of the control group (less than 0.25 microg/L). The patients who had total knee arthroplasty had molybdenum profiles that were similar to those of the control group (median, 2.11 microg/L).

Hip resurfacing in patients under thirty years old: an attractive option for young and active patients

“…In fact, the carcinogenic risk is not increased in subjects receiving metalon-metal hip prostheses compared to those with metal-onpolyethylene hip prostheses [33,37]. All metal implants release metal ions because of corrosion effects for instance after total knee arthroplasty which show metallic ion levels similar to those in metal-on-metal hip arthroplasty [22].…”

Does Ion Release Differ Between Hip Resurfacing and Metal-on-metal THA?

“…Several studies evaluated ion release in the presence of metallic implants in the hip [8,30] and the knee [23]. There are many complex issues associated with analysis of metal ions, including collection technique, analysis, statistical methodology, and reporting of the results.…”

Update on UHMWPE research From the bench to the bedside

“…However, disadvantages have been stressed when the accession of metal-on-metal (MOM) and ceramic-on-ceramic (COC) friction pairs of newer generations, presently in use for the hip, provide harsh competition to the conventional metal-on-UHMWPE joint. In view of these alternative bearings, where different complications may appear due to clearance (Brockett et al 2008), ion release (Witzleb et al 2006, Luetzner et al 2007), or even potential fracture (Barrack et al 2004, Popescu et al 2008, research has been increased to meet challenges developed over the three facets of the current UHMWPE paradigm of the polyethylene over 3 axes ( Figure 2). These challenges include (1) achieving enough wear resistance to avoid or delay osteolysis and (2) Figure 1.…”