Evidence map›Paper›PMID 42384121›Full record

ArticleInternational orthopaedics2026

Patterns of blood cobalt levels after metal-on-metal total hip arthroplasty, predictors of elevated levels, and associations with clinical symptoms.

Amanda I Gonzalez, Nicolas Silvestrini, Cody Fournier, Christophe Barea, Robin Peter, Pierre Hoffmeyer, Didier Hannouche, Anne Lübbeke

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Article in International orthopaedics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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.

2 · The registry

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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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Amanda I GonzalezDivision of Orthopaedics and Trauma Surgery, University Hospitals of Geneva, Geneva, Switzerland. Amanda.gonzalez@hug.ch.ORCID 0000-0001-9231-0353
Nicolas SilvestriniDivision of Orthopaedics and Trauma Surgery, University Hospitals of Geneva, Geneva, Switzerland.
Cody FournierDivision of Orthopaedics and Trauma Surgery, University Hospitals of Geneva, Geneva, Switzerland.
Christophe BareaDivision of Orthopaedics and Trauma Surgery, University Hospitals of Geneva, Geneva, Switzerland.
Robin PeterGénérale-Beaulieu Clinic, Geneva, Switzerland.
Pierre HoffmeyerSWISS Foundation for Innovation and Training in Surgery, Geneva, Switzerland.
Didier HannoucheDivision of Orthopaedics and Trauma Surgery, University Hospitals of Geneva, Geneva, Switzerland.
Anne LübbekeDivision of Orthopaedics and Trauma Surgery, University Hospitals of Geneva, Geneva, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeObjectives were to assess patterns of blood cobalt levels over time in MoM THAs by head size; predictors of elevated cobalt levels; and associations between cobalt levels and clinical outcomes.

methodsWe included all primary MoM THAs performed 1998-2011 with postoperative blood cobalt concentrations. We stratified the MoM THAs in ≤ 36 mm vs. > 36 mm.

resultsOverall, 526 MoM THAs were included: 427 with small and 99 with large heads. Considering patients with at least two serologies before revision (n = 205), cobalt levels were higher for patients with large compared to small heads (medians: 3.5 vs. 1.3, p < 0.001). We did not find any effect of time on cobalt levels between the two consecutive serologies (p > 0.42) or when using time as a continuous variable (p > 0.55). For large heads women were more likely to show elevated cobalt levels than men (adjusted OR = 3.56, 95% CI 1.17-10.84, p = 0.02). We did not find any significant association between cobalt levels and clinical outcomes (Spearman's rs < 0.08, ps > 0.15).

conclusionWe observed stable cobalt levels over time in small and large MoM THAs. Repeat laboratory workups in small and large head MoM THAs seem unnecessary given that the cobalt values remained stable.

Indexed as

Arthroplasty, Replacement, HipCobaltHip ProsthesisMetal-on-Metal Joint ProsthesesAdultAgedFemaleHumansMaleMiddle AgedProsthesis DesignProsthesis FailureReoperationRetrospective StudiesTreatment OutcomeCobaltCobalt levelsHead sizeMetal-on-metalTotal hip arthroplasty

Identifiers

PMID42384121
PMCPMC13562104

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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.