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Blood cobalt ion level in patients with different sizes of cobalt/chrome femoral head with the Accolade TMZF stem

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A Letter to the Editor to this article was published on 03 October 2022

Abstract

Background

Corrosion of stem-cobalt/chromium (Co/Cr) head interface and subsequent systemic Co ion complication have been a clinical concern after total hip arthroplasty (THA). The aim of this study is to investigate correlation between type of femoral head and blood Co ion level.

Methods

One hundred four patients with THA using accolade TMZF and Co/Cr femoral head (32-mm; 55 cases, 36-mm; 20 cases, dual mobility system (DM) with 22.2 or 28-mm inner head; 29 cases) participated in this study, and blood Co ion concentration test was performed in patients a minimum of four years after THA.

Results

DM group was significantly older than 32-mm and 36-mm group (DM: 73.9 ± 4.6, 32-mm: 63.3 ± 8.5, 36-mm: 66.8 ± 10.5). The median (interquartile range) blood Co concentration of each group was 32-mm group 0.26 µg/L (0.69), 36-mm group; 0.21 µg/L (0.30); and DM group 0.21 µg/L (0.13). There was a significant difference of Co concentration between DM and 32-mm group (p = 0.023). Abnormal values of the blood Co concentration (> 1 µg/L) were observed in the 32-mm group; 12 cases (21.8%), 36-mm group; 2 cases (10.0%); and DM group; 0 case (0%) (p = 0.018).

Conclusions

Co blood concentration differed among the different sizes of Co/Cr femoral head. THA using DM is a safe option with low risk of complication from cobalt ion if it is used for elderly patients.

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Acknowledgements

We thank Prof. Hanawa Takao for his outstanding advice about metallic biomaterials.

Funding

This study was partly supported by JSPS KAKENHI Grant Number 19H01081.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Seiya Ishii, Yasuhiro Homma, Tomonori Baba, Kazuo Kaneko & Muneaki Ishijima

  2. Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Takehisa Matsukawa

  3. Department of Forensic Medicine, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Takehisa Matsukawa

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  1. Seiya Ishii
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Contributions

YH conceived and designed this research. YH, TB, and IS obtained the data. MT, YH, and SI analyzed data. SI wrote the initial manuscript. YH revised the manuscript. YH, SI, KK, TB, and IM interpretated the data. All authors read and approved the manuscript.

Corresponding author

Correspondence to Yasuhiro Homma.

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This study was approved by the Inst. Ethical Review Board.

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Ishii, S., Homma, Y., Matsukawa, T. et al. Blood cobalt ion level in patients with different sizes of cobalt/chrome femoral head with the Accolade TMZF stem. International Orthopaedics (SICOT) 46, 2205–2212 (2022). https://doi.org/10.1007/s00264-022-05502-1

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