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Comparison of chromium and cobalt serum levels between a modular neck stem and its monoblock counterpart in primary total hip arthroplasty

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

Abstract

Background

The addition of junctions in modular stems implies a greater susceptibility to corrosion.

Purpose

The aim of this study is to compare serum chromium and cobalt levels after using a bimodular stem and its monoblock counterpart in primary total hip arthroplasty. Postoperative clinical scores were also compared.

Patients and methods

A prospective cohort study between 2012 and 2015 was designed. One arm of the cohort included patients with the cementless modular neck stem H-Max M® and the other with the cementless monoblock stem counterpart H-Max S®.

Results

No statistically significant difference was found in chromium value between groups (p = 0.621) at two years postoperative. Cobalt value was higher in the modular group (p = < 0.001). No statistically significant difference was found in clinical postoperative scores except for the Harris Hip Score, with better results at six months in modular group (p = 0.007).

Conclusions

Higher serum cobalt level in the modular group has limited the use of modular stems in our daily practice. Advantages of modular stem were not found.

Level of evidence

II.

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Authors and Affiliations

  1. Doctor Peset University Hospital, Av. Gaspar Aguilar 90, 46017, Valencia, Spain

    R. E. López, J. M. Pelayo de Tomás & J. L. Rodrigo Pérez

  2. School of Medicine, Valencia University, Av. Blasco Ibañez, 15, 46010, Valencia, Spain

    J. M. Pelayo de Tomás & J. L. Rodrigo Pérez

  3. Unit of Public Health, Hygiene and Enviromental Health, Departament of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, School of Pharmacy, Av. Vicente Andrés Estellés, Burjassot, Valencia, Spain

    M. Morales Suárez Varela

  4. CIBER of Epidemiology and Public Health (CIBERESP), Av. Monforte De Lemos 3-5, Pavillon 11, Floor 0, 28029, Madrid, Spain

    M. Morales Suárez Varela

Authors
  1. R. E. López
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  2. J. M. Pelayo de Tomás
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  3. M. Morales Suárez Varela
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  4. J. L. Rodrigo Pérez
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Correspondence to R. E. López.

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The authors declare that they have no conflict of interest and no financial support.

Ethical approval

This study was approved by our Institutional Ethics Committee (CEIC Hospital Doctor Peset de Valencia, reference 110/17) and performed in accordance 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 in order to analyze and publish their data. Location: This study was carried out at Doctor Peset University Hospital.

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López, R.E., Pelayo de Tomás, J.M., Morales Suárez Varela, M. et al. Comparison of chromium and cobalt serum levels between a modular neck stem and its monoblock counterpart in primary total hip arthroplasty. Eur J Orthop Surg Traumatol 33, 3403–3409 (2023). https://doi.org/10.1007/s00590-023-03567-1

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  • DOI: https://doi.org/10.1007/s00590-023-03567-1

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