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Metal ion release after hip resurfacing arthroplasty and knee arthroplasty: a retrospective study of one hundred ninety-five cases

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Abstract

Purpose

Hip arthroplasty with metal-on-metal bearings like hip resurfacing results in the release of metallic ions. In parallel, like every metallic implant, knee arthroplasty implants undergo passive corrosion. We analyzed blood levels of cobalt and chromium ions in patients who have a hip resurfacing arthroplasty and compared them to patients who have undergone knee arthroplasty at a minimum follow-up of one year. The hypothesis was that there is no difference in the ion release between hip resurfacing and knee arthroplasty.

Methods

Sixty-three patients who underwent knee arthroplasty were compared to a cohort of 132 patients who underwent hip resurfacing. The blood levels of cobalt and chromium ions were determined preoperatively and at six and 12 months postoperatively and then compared between groups. We analyzed the relationship between ion release and the change in clinical outcome scores (Harris Hip score, Oxford Hip score, Merle D’Aubigné Postel score, Oxford Knee score, International Knee Society score), the BMI, sex, physical activity, implant size and inclination of the acetabular implant (hip resurfacing patients only). Mixed linear models were used to assess the changes in ion blood levels over time.

Results

The cobalt blood levels were higher in the first 6 months in the resurfacing group (0.87 ug/L vs 0.67 ug/L; p = 0.011), while it was higher in the knee arthroplasty group at 12 months (1.20 ug/L vs 1.41 ug/L; p = 0.0008). There were no significant differences in chromium levels during the follow-up period.

Conclusion

The increase in metal ion release after knee arthroplasty is as high as after hip resurfacing at the one year follow-up. The monitoring of this parameter probably should not be recommended in case of good clinicals outcomes.

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Author information

Authors and Affiliations

  1. Univ. Lille, CHU Lille, ULR 4490-PMOI, F-59000, Lille, France

    S. Lukas, S. Putman, H. Migaud & J. Girard

  2. Service d’Orthopédie, Hôpital Salengro, Place de Verdun, CHU Lille, F-59000, Lille, France

    S. Lukas, S. Putman, H. Migaud & J. Girard

  3. Département de Chirurgie Orthopédique, Hôpital Saint Philibert, Université Catholique de Lille, Lomme, France

    P. Martinot & A. Lons

  4. Unité de Biostatistiques, Université Lille, Centre Hospitalier Universitaire Lille, EA 2694–Santé publique: épidémiologie et qualité des soins, F-59000, Lille, France

    E. Drumez

  5. Univ. Lille, Univ. Artois, Univ. Littoral Côte d’Opale, EA 7369–URePSS–Unité de Recherche Pluridisciplinaire Sport Santé Société, F-59000, Lille, France

    J. Girard

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Contributions

Simon Lukas: data acquisition, analysis and interpretation, and writing of the article. Pierre Martinot: writing of the article and critical review of the article for its intellectual content. Adrien Lons: critical review of the article for its intellectual content. Elodie Drumez: statistics. Julien Girard: critical review of the article for its intellectual content. Sophie Putman: critical review of the article for its intellectual content. Henri Migaud and Julien Girard: critical review of the article for its intellectual content and final approval of the version to be submitted.

Corresponding author

Correspondence to S. Lukas.

Ethics declarations

Ethics approval

According to French law, we did not provide an IRB because the carry out of a retrospective study involving a classic patient follow-up does not fall within the framework of an ethics committee.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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None.

Competing interests

The other authors declare no competing interests. Ortherwise, Henri Migaud is an education and research consultant for Zimmer, Corin, SERF, MSD and chief editor for Orthopaedics & Traumatology: Surgery & Research (Elsevier), Sophie Putman is an education and research consultant for Corin, Julien Girard is an education and research consultant for Microport, Smith & Nephew and Zimmer-Biomet.

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Lukas, S., Martinot, P., Putman, S. et al. Metal ion release after hip resurfacing arthroplasty and knee arthroplasty: a retrospective study of one hundred ninety-five cases. International Orthopaedics (SICOT) 48, 119–126 (2024). https://doi.org/10.1007/s00264-023-05915-6

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