ArticleJournal of orthopaedics
Self-reported systemic complaints in patients with metal-on-metal hip arthroplasty.
Article in Journal of orthopaedics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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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.
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Who cites it
3 citing papers in PubMed, 5 citations in OpenAlex.
- Development of endothelial injury under chemical hypoxia: early migration impairment precedes cytotoxicity in CoClMolecular biology reports · 2026Article
- Research progress on nanotoxicity and detoxification of cobalt in metal-based implants.Annals of medicine · 2025Review
- Long-Term Effects of Metal-on-Metal Cobalt-Chromium-Containing Prostheses Used in Total Knee Arthroplasty on Hearing and Tinnitus.Sisli Etfal Hastanesi tip bulteni · 2022Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAn increase in blood serum metal ion levels is seen after implantation of all metal-on-metal (MoM) hip prosthesis. Systemic complaints contributed to raised cobalt ion concentrations in patients with MoM arthroplasty may lead to a variety of symptoms. The aim of this study is to investigate self-reported systemic complaints in association with cobalt ion concentrations in patients with any type of MoM hip prosthesis.
methodsA cohort study was conducted. Patients with both unilateral and bilateral, resurfacing and large head metal on metal total hip arthroplasties (LHMoM THA) were included. Cobalt ion concentrations were measured by inductively coupled plasma mass spectrometry. Based on the known cobalt toxicity symptoms of case-reports and toxicology reports a new non-validated questionnaire was developed. Analysis was performed on two groups; a low cobalt ion concentration group and a high cobalt ion concentration group.
resultsA total of 62 patients were included with a mean age at surgery of 60.8 ± 9.3 years and a mean follow up of 6.3 ± 1.4 years. Mean cobalt ion concentrations were 104 ± 141 nmol/L (9-833). Based on the different thresholds (120-170 or 220 nmol/L) the low cobalt ion concentration group consisted of 44 (71%), 51 (82%) or 55 (89%) subjects respectively. In the 120 nmol/L and 170 nmol/L thresholds a significant difference in age was found. The composite score for OVS increased from 54% to 57%-68% with rising threshold value, a hint at the correlation between ion concentration and symptom prevalence. DISCUSSION: Ocular-vestibular symptoms were more common in high cobalt ion concentration groups for the three threshold levels tested and with increasing prevalence for higher threshold values. With regards to proactively inquired, self-reported symptoms the threshold where effects may be present could be lower than values currently applied in clinical follow-up.
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