The value of serial metal ion levels in following up patients with metal-on-metal hip arthroplasty
Hip Int 2017; 27(1): 14 - 20
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsGavin McHugh, Rajiv Merchant, Gabrielle E. Kelly, Karen M. Bergin, Gerald F. McCoy, Andrew P. Wozniak, John F. Quinlan
The sensitivity of cobalt (Co) and chromium (Cr) ion-levels in detecting poorly performing metal-on-metal hip implants is low. This study proposes that serial changes in ion-levels are a more accurate marker of arthroplasties at risk.
Serial metal ion-levels and implant data of 285 patients with ASR resurfacing or replacement were studied. Patient and implant characteristics were analysed using univariate and multivariate analyses.
111 (39%) had revision surgery. Time since index surgery (p<0.001), acetabular inclination (p<0.001), their interaction (p<0.001) and femoral head size (p = 0.01) were significant variables. Head size (≤51 mm) had lower Co and Cr levels (p = 0.01). Cr/Co showed marginal decrease over time in the unrevised group and no decrease prerevision.
Repeated measurement of ion-levels were higher in the revision group suggesting that serial measurements rather than absolute values may have a role to play in predicting implant failure.
- • Accepted on 17/06/2016
- • Available online on 20/01/2017
- • Published in print on 21/02/2017
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- McHugh, Gavin [PubMed] [Google Scholar] 1
- Merchant, Rajiv [PubMed] [Google Scholar] 1, * Corresponding Author (firstname.lastname@example.org)
- Kelly, Gabrielle E. [PubMed] [Google Scholar] 2
- Bergin, Karen M. [PubMed] [Google Scholar] 1
- McCoy, Gerald F. [PubMed] [Google Scholar] 1
- Wozniak, Andrew P. [PubMed] [Google Scholar] 1
- Quinlan, John F. [PubMed] [Google Scholar] 1
Lourdes Orthopaedic Hospital, Kilcreene, Kilkenny - Ireland
School of Mathematical Sciences, University College Dublin, Dublin - Ireland