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  • Comparison of synovial fluid, urine, and serum ion levels in metal-on-metal total hip arthroplasty at a minimum follow-up of 18 years.

Comparison of synovial fluid, urine, and serum ion levels in metal-on-metal total hip arthroplasty at a minimum follow-up of 18 years.

Journal of orthopaedic research : official publication of the Orthopaedic Research Society (2014-05-21)
Richard Lass, Alexander Grübl, Alexander Kolb, David Stelzeneder, Alexander Pilger, Bernd Kubista, Alexander Giurea, Reinhard Windhager
ABSTRACT

Diagnosis of adverse reactions to metal debris in metal-on-metal hip arthroplasty is a multifactorial process. Systemic ion levels are just one factor in the evaluation and should not be relied upon solely to determine the need for revision surgery. Furthermore, the correlation between cobalt or chromium serum, urine, or synovial fluid levels and adverse local tissue reactions is still incompletely understood. The hypothesis was that elevated serum and urine metal-ion concentrations are associated with elevated local metal-ion concentrations in primary total hip arthroplasties (THA) and with failure of metal-on-metal articulations in the long-term. In our present study, we evaluated these concentrations in 105 cementless THA with metal-on-metal articulating surfaces with small head diameter at a minimum of 18 years postoperatively. Spearman correlation showed a high correlation between the joint fluid aspirate concentration of cobalt and chromium with the serum cobalt (r = 0.81) and chromium level (r = 0.77) in patients with the THA as the only source of metal-ions. In these patients serum metal-ion analysis is a valuable method for screening. In patients with more than one source of metal or renal insufficiency additional investigations, like joint aspirations are an important tool for evaluation of wear and adverse tissue reactions in metal-on-metal THA.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Chromium, chips, thickness ~2 mm, 99.5%
Sigma-Aldrich
Chromium, chips, 99.995% trace metals basis
Sigma-Aldrich
Cobalt, foil, thickness 1.0 mm, 99.95% trace metals basis
Sigma-Aldrich
Cobalt, powder, <150 μm, ≥99.9% trace metals basis
Sigma-Aldrich
Cobalt, rod, diam. 5.0 mm, 99.95% trace metals basis
Sigma-Aldrich
Cobalt, foil, thickness 0.25 mm, ≥99.99% trace metals basis
Sigma-Aldrich
Cobalt, powder, 2 μm particle size, 99.8% trace metals basis
Sigma-Aldrich
Cobalt, foil, thickness 0.1 mm, 99.95% trace metals basis
Sigma-Aldrich
Chromium, powder, ≥99% trace metals basis, <45 μm
Sigma-Aldrich
Chromium, powder, 99.5%, −100 mesh
Sigma-Aldrich
Cobalt, rod, diam. 5.0 mm, 99.998% trace metals basis
Sigma-Aldrich
Cobalt, pieces, 99.5% trace metals basis
Sigma-Aldrich
Cobalt, granular, 99.99% trace metals basis
Sigma-Aldrich
Cobalt, Carbon coated magnetic, nanopowder, <50 nm particle size (TEM), ≥99%
Cobalt, foil, not light tested, 50x50mm, thickness 0.004mm, 99.9%
Cobalt, foil, not light tested, 100x100mm, thickness 0.05mm, as rolled, 99.9%
Cobalt, foil, 8mm disks, thickness 0.25mm, as rolled, 99.9%
Cobalt, foil, 6mm disks, thickness 0.25mm, as rolled, 99.99+%
Cobalt, foil, light tested, 50x50mm, thickness 0.015mm, 99.9%
Cobalt, foil, not light tested, 25x25mm, thickness 0.006mm, 99.9%
Cobalt, foil, not light tested, 50x50mm, thickness 0.002mm, temporary acrylic support, 99.9%
Cobalt, foil, not light tested, 100x100mm, thickness 0.025mm, 99.9%
Cobalt, foil, 4mm disks, thickness 0.25mm, as rolled, 99.9%
Cobalt, foil, light tested, 25x25mm, thickness 0.009mm, 99.9%
Cobalt, foil, 6mm disks, thickness 0.009mm, 99.9%
Cobalt, foil, not light tested, 150x150mm, thickness 0.0125mm, 99.9%
Cobalt, foil, not light tested, 25x25mm, thickness 0.007mm, 99.9%
Cobalt, foil, not light tested, 100x100mm, thickness 0.004mm, 99.9%
Cobalt, foil, 6mm disks, thickness 0.01mm, 99.9%
Cobalt, foil, not light tested, 150x150mm, thickness 0.01mm, 99.9%