Clinical Orthopaedics and Related Research

, Volume 467, Issue 1, pp 101–111

2008 John Charnley Award: Metal Ion Levels After Metal-on-Metal Total Hip Arthroplasty: A Randomized Trial

  • C. Anderson EnghJr.
  • Steven J. MacDonald
  • Supatra Sritulanondha
  • Abigail Thompson
  • Douglas Naudie
  • Charles A. Engh
Symposium: Papers Presented at the Hip Society Meetings 2008

DOI: 10.1007/s11999-008-0540-9

Cite this article as:
Engh, C.A., MacDonald, S.J., Sritulanondha, S. et al. Clin Orthop Relat Res (2009) 467: 101. doi:10.1007/s11999-008-0540-9

Abstract

Metal-on-metal bearing total hip arthroplasty is performed more commonly than in the past. There may be manufacturing differences such as clearance, roughness, metallurgy, and head size that affect performance. In a prospective, randomized trial, we compared 2-year postoperative ion levels for a 28-mm metal-on-polyethylene bearing with 28-mm and 36-mm metal-on-metal bearings. We measured serum, erythrocyte, and urine ion levels. We observed no difference in the ion levels for the 28-mm and 36-mm metal-on-metal bearings. The ion levels in these patients were lower than reported for most other metal-on-metal bearings. Although both erythrocyte and serum cobalt increased, erythrocyte chromium and erythrocyte titanium did not increase despite a four- to sixfold serum chromium and a three- to fourfold serum titanium increase. This may represent a threshold level for serum chromium and serum titanium below which erythrocytes are not affected.

Level of Evidence: Level I, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Copyright information

© The Association of Bone and Joint Surgeons 2008

Authors and Affiliations

  • C. Anderson EnghJr.
    • 1
  • Steven J. MacDonald
    • 2
  • Supatra Sritulanondha
    • 1
  • Abigail Thompson
    • 2
  • Douglas Naudie
    • 2
  • Charles A. Engh
    • 1
  1. 1.Anderson Orthopaedic Research InstituteAlexandriaUSA
  2. 2.Division of Orthopaedic SurgeryUniversity of Western Ontario and London Health Sciences CentreLondonCanada