[Measurement of chromium and cobalt ions in metal-on-metal total hip arthroplasty].

INTRODUCTION

New metal-on-metal hip replacement models emerged in the 1990 with modifications of the previous designs and alloys. This led to expect a lesser rate of ion and particle release in the body with the resulting decrease in wear, osteolysis and loosening.

OBJECTIVE

To measure blood and urine chromium and cobalt ions in a 28 mm metal-on-metal tribology during the first postoperative year.

MATERIAL AND

METHODS

Blood and urine cobalt and chromium concentrations were measured in 10 patients (13 prostheses) with the atomic absorption method. The etiology was studied and they were functionally assessed with the Harris functional scale. Adverse metal reactions were also assessed.

RESULTS

8 male and 2 female patients, mean age 54.5 years; 6 had primary coxarthrosis, one was post-traumatic, and 3 had avascular necrosis. The final assessment according to the Harris scale was 92 points. Mean blood chromium was 1.26 ng/l, blood cobalt was 1.033 microg/l; (reference values: chromium 1.4 ng/l and cobalt 1.8 microg/l); only one figure, in a female patient, was found to be higher than normal (chromium 21.2 ng/l and cobalt 15.4 microg/l). Mean urine chromium was 0.95 ng/ml, urine cobalt was 0.53 microg/l (Reference values: chromium: 2.0 ng/ml and cobalt 0.5 microg/l).

CONCLUSIONS

All patients, with the exception of a female patient, were within the normal ranges. No adverse effect was observed in patients with metal implants with a 28 mm tribology.