Trial reportActa orthopaedica2013
Metal ion levels and lymphocyte counts: ASR hip resurfacing prosthesis vs. standard THA: 2-year results from a randomized study.
Trial report in Acta orthopaedica, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01113762 (Metal-metal Articulations vs Standard 28 mm Cementless Total Hip Arthroplasty in Younger Patients. Randomized Studies), which is not on this map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Metal-metal Articulations vs Standard 28 mm Cementless Total Hip Arthroplasty in Younger Patients. Randomized Studies
Who cites it
11 citing papers in PubMed, 22 citations in OpenAlex.
- Independent and Combined Associations between Metals Exposure and Inflammatory Markers among the General U.S. Adults.Environment & health (Washington, D.C.) · 2025Article
- Hematological Response to Particle Debris Generated During Wear-Corrosion Processes of CoCr Surfaces Modified with Graphene Oxide and Hyaluronic Acid for Joint Prostheses.Nanomaterials (Basel, Switzerland) · 2024Article
- Metal ion levels after metal-on-metal hip resurfacing: A single-center longitudinal study of Chinese patients.Acta orthopaedica et traumatologica turcica · 2024Article
- The roles of essential trace elements in T cell biology.Journal of cellular and molecular medicine · 2024Review
- No association between blood count levels and whole-blood cobalt and chromium levels in 1,900 patients with metal-on-metal hip arthroplasty.Acta orthopaedica · 2020Article
- Peripheral Blood Lymphocyte Subpopulations in Patients Following Small Diameter Metal-On-Metal Total Hip Replacement at Long-Term Follow-Up.Journal of clinical medicine · 2020Article
- Overview of Randomized Controlled Trials in Primary Total Hip Arthroplasty (34,020 Patients): What Have We Learnt?Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2020Review
- Worse health-related quality of life and hip function in female patients with elevated chromium levels.Acta orthopaedica · 2016Article
- Increased expression of inducible co-stimulator on CD4+ T-cells in the peripheral blood and synovial fluid of patients with failed hip arthroplasties.Bone & joint research · 2016Article
- Has Metal-On-Metal Resurfacing Been a Cost-Effective Intervention for Health Care Providers?-A Registry Based Study.PloS one · 2016Article
- High metal ion levels after use of the ASR™ device correlate with development of pseudotumors and T cell activation.Clinical orthopaedics and related research · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeWear particles from metal-on-metal arthroplasties are under suspicion for adverse effects both locally and systemically, and the DePuy ASR Hip Resurfacing System (RHA) has above-average failure rates. We compared lymphocyte counts in RHA and total hip arthroplasty (THA) and investigated whether cobalt and chromium ions affected the lymphocyte counts.
methodIn a randomized controlled trial, we followed 19 RHA patients and 19 THA patients. Lymphocyte subsets and chromium and cobalt ion concentrations were measured at baseline, at 8 weeks, at 6 months, and at 1 and 2 years.
resultsThe T-lymphocyte counts for both implant types declined over the 2-year period. This decline was statistically significant for CD3(+)CD8(+) in the THA group, with a regression coefficient of -0.04 × 10(9)cells/year (95% CI: -0.08 to -0.01). Regression analysis indicated a depressive effect of cobalt ions in particular on T-cells with 2-year whole-blood cobalt regression coefficients for CD3+ of -0.10 (95% CI: -0.16 to -0.04) × 10(9) cells/parts per billion (ppb), for CD3+CD4+ of -0.06 (-0.09 to -0.03) × 10(9) cells/ppb, and for CD3(+)CD8(+) of -0.02 (-0.03 to -0.00) × 10(9) cells/ppb.
interpretationCirculating T-lymphocyte levels may decline after surgery, regardless of implant type. Metal ions-particularly cobalt-may have a general depressive effect on T- and B-lymphocyte levels. Registered with ClinicalTrials.gov under # NCT01113762.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.