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False profile view is independently associated with serum metal levels in patients with metal-on-metal hip arthroplasty

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Elevated levels of serum metal ions can be found in some patients with metal-on-metal (MoM) hip replacements. This study seeks to identify whether there is a significant association between the contact patch to rim distance (CPRD) and the anterior center edge angle (ACEA), respectively, and serum cobalt (Co) and chromium (Cr) levels in patients treated with unilateral MoM hip replacements by using standing anteroposterior and false profile view radiographs.

Methods

This is a retrospective analysis on 53 patients with either unilateral ReCap or M2a-Magnum MoM hip replacements operated in 2006 or 2007. Univariate linear regression and multivariable linear regression (MLR) analyses were performed using the CPRD and ACEA along with risk factors for elevated serum levels of Co and Cr previously suggested in the literature as explanatory variables. Serum Co and Cr were measured using inductively coupled plasma mass spectrometry.

Results

The MLR model showed that the same three variables (gender, CPRD and ACEA) were significantly associated with serum levels of both Co and Cr explaining approximately half of the variation. A univariate analysis showed a polynomial association between both anteversion angle and the ACEA with serum levels of Co and Cr. The vertex of the polynomial function was located at approximately 20° and 40°, respectively.

Conclusion

Gender, CPRD and ACEA are independently associated with serum levels of Co and Cr. Both ACEA and anteversion angles have optimae associated with low serum metal levels which may be useful for post-surgery evaluation of cup positioning.

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Author notes

  1. Arne Borgwardt: Deceased January 6th 2020.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Bispebjerg and Frederiksberg University Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark

    Bo Madvig Larsen, Arne Borgwardt & Søren Ribel-Madsen

  2. Department of Clinical Physiology and Nuclear Medicine, Herlev University Hospital, Borgmester Ib Juuls Vej 1, Herlev, 2730, Denmark

    Bo Zerahn

Authors
  1. Bo Madvig Larsen
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  2. Arne Borgwardt
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  3. Søren Ribel-Madsen
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  4. Bo Zerahn
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Contributions

AB, BZ and SR-M designed the study. AB and SR-M performed the clinical controls and collected data. BML and BZ took the lead in writing the manuscript and performed data processing. BZ performed the statistical calculations. All authors provided critical feedback and helped shape the research, analysis and manuscript.

Corresponding author

Correspondence to Bo Madvig Larsen.

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Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical Approval

This study was approved by the local ethics committee as protocol KF 01–157/04.

Human or Animal Rights

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.

Consent to participate

Patients gave their written informed consent before participating and the study.

Consent for publication

Patients signed informed consent regarding publishing their data.

Data availability

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

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Not applicable.

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Larsen, B.M., Borgwardt, A., Ribel-Madsen, S. et al. False profile view is independently associated with serum metal levels in patients with metal-on-metal hip arthroplasty. Eur J Orthop Surg Traumatol 31, 1029–1036 (2021). https://doi.org/10.1007/s00590-020-02839-4

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  • DOI: https://doi.org/10.1007/s00590-020-02839-4

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