ArticleArchives of orthopaedic and trauma surgery2023
Do cobalt and chromium blood metal ion levels normalize after revision of failed metal-on-metal total hip replacements?
Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- High Complication Rates Following Revision of Aseptic Metal-on-Metal Hips to Dual Mobility Bearings.Arthroplasty today · 2026Article
- Outcomes of direct anterior approach for uncemented total hip replacement in medial femoral neck fractures: a retrospective comparative study on the first 100 consecutive patients.BMC musculoskeletal disorders · 2023Article
- Hip resurfacing and posterior approach total hip arthroplasty have equivalent blood loss when tranexamic acid is used: a propensity score matched cohort analysis.Archives of orthopaedic and trauma surgery · 2022Article
- Tranexamic acid reduces blood loss in primary total hip arthroplasty performed using the direct anterior approach: a one-center retrospective observational study.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2022Observational
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Authors and funding
6 authors.
Funding
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Abstract
introductionIncreased cobalt (Co) and chromium (Cr) serum levels are one reason for revision surgery in metal on metal (MoM) total hip arthroplasty (THA) patients. Dual mobility liners are a simple revision option; however, they preserve the metal shell and stem and it is therefore not clear if metal ion levels will fully normalize after revision surgery. MATERIAL AND
methodsBetween April 2013 and December 2017 25 hips (24 patients) underwent revision from a MoM THA to an off-label dual mobility liner. Five patients were lost to follow-up and one patient refused leaving 18 patients (11 men, 7 female, average age 63.9 years) for pre- and postoperative metal ion level blood tests at a minimum follow-up of 2 years.
resultsFourteen patients were revised for osteolysis, two for elevated metal ion levels and two for fluid or cysts around the femoral or acetabular component. The average preoperative Co and Cr levels were 8.3 µg/l and 5.0 µg/l, respectively. At a minimum follow-up of 2 years (30-95 months), metal ions dropped to 0.8 µg/l. Harris Hip Score (HHS), Hip Osteoarthritis Outcome Score (HOOS), Visual Analog Scale (VAS) and the UCLA activity score improved non-significantly from pre- to postoperative. There was one postoperative complication in the study cohort. One patient with persisting pain required revision surgery to a standard acetabular component during the follow-up period.
conclusionThe off-label use of a dual-mobility liner in the current study resulted in normalization of the metal ion levels suggesting that preserving the cobalt-chromium acetabular component has little impact on ion levels. In addition, dual mobility liners have a low complication and revision rate.
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