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Potential presence of metals in patients treated with metal–metal coupling prostheses for hip arthroplasty at 7 and 10 years of follow-up

  • Original Article • HIP - ARTHROPLASTY
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Beginning in 2008, metal-on-metal prostheses have been in the spotlight owing to much higher revision rates than expected. Adverse local tissue reactions have been well described in the literature as potential complications.

Methods

Between 2012 and 2013, 13 patients with metal-on-metal total hip replacements were evaluated clinically and radiologically and with laboratory samples. The same tests were repeated between 2015 and 2016 on eight patients to assess any changes. In the laboratory assessment, we searched for chromium, cobalt, molybdenum, and nickel in blood and urine samples over 24 h.

Results

Clinical assessment has shown good score in all patients except one. On a second examination, between 2015 and 2016, all patients obtained results similar to those obtained in the first assessment, except a patient, who reported a recent fall. In the radiological assessment between 2012 and 2013, results were optimal, apart from a case of aseptic mobilization. The patients reassessed 3 years after the first examination showed radiological results similar to those previously obtained, apart from a patient, who showed signals of mobilization. Metal levels found in their blood decreased in most cases after 3 years. Urine levels of nickel increased in five subjects, and chromium levels increased in four, but levels of cobalt and molybdenum decreased in four patients.

Conclusion

It could be hypothesized that the decreasing trend of metal ion levels is associated with a stable wear status. On the contrary, a progressive increase in metal ion levels must be considered as early proof of implant loosening.

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Abbreviations

MOM:

Metal on metal

THA:

Total hip arthroplasty

ALTRs:

Adverse local tissue reactions

ICP-MS:

Inductively coupled plasma–mass spectrometry

SCENIHR:

Scientific Committee on Emerging and Newly Identified Health Risks

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Funding

This study was funded by the authors.

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Authors and Affiliations

  1. Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy

    Giuseppe Sessa, Gianluca Testa, Salvatore Gioitta Iachino, Luciano Costarella, Calogero Puma Pagliarello & Vito Pavone

  2. Department of Medical, Surgical and Advanced Technologies ‘G.F. Ingrassia’, University of Catania, Catania, Italy

    Margherita Ferrante & Alfina Grasso

Authors
  1. Giuseppe Sessa
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  2. Gianluca Testa
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  3. Salvatore Gioitta Iachino
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  4. Luciano Costarella
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  5. Calogero Puma Pagliarello
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  6. Margherita Ferrante
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  7. Alfina Grasso
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  8. Vito Pavone
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Corresponding author

Correspondence to Gianluca Testa.

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Each author certifies that he/she has no commercial associations that might pose a conflict of interest in connection with the submitted article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Cite this article

Sessa, G., Testa, G., Gioitta Iachino, S. et al. Potential presence of metals in patients treated with metal–metal coupling prostheses for hip arthroplasty at 7 and 10 years of follow-up. Eur J Orthop Surg Traumatol 28, 637–643 (2018). https://doi.org/10.1007/s00590-018-2129-7

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  • DOI: https://doi.org/10.1007/s00590-018-2129-7

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