Skip to main content
SpringerLink
Log in

Serum and urine metal levels in patients with metal-on-metal surface arthroplasty

  • Published:
Journal of Materials Science: Materials in Medicine Aims and scope Submit manuscript

Abstract

The resurgence of metal-on-metal articulating surfaces for hip arthroplasty has also heightened concerns about the degree and magnitude of metal particle generation and the accompanying increase in circulating metal ion concentrations. In this study, we measured the concentration of chromium in serum and urine and the concentration of cobalt in serum in twenty-five patients with modern metal-on-metal surface arthroplasty of the hip in a prospective manner. The results showed that the mean post-operative chromium in serum levels were 22-fold, 23-fold and 21-fold higher at 3, 6 and 12 months post-operative, respectively, than pre-operative levels. The mean post-operative cobalt in serum levels were 8-fold, 7-fold and 6-fold higher at 3, 6 and 12 months post-operative, respectively, than pre-operative levels. The mean post-operative chromium in urine levels were 9-fold, 10-fold and 14-fold higher at 3, 6 and 12 months post-operative, respectively, than pre-operative levels. The values seen in this study with the current generation of surface arthroplasties are: (a) lower than those seen in an earlier generation of surface arthroplasties; (b) in the same range as those observed in association with metal-on-metal conventional total hip replacements, which typically have smaller head sizes; (c) higher than values observed in patients with conventional metal-on-polyethylene articulating couples.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. M. E. Steinberg, Orthop. Clin. North Am. 13 (1982) 661.

    Google Scholar 

  2. H. C. Amstutz, in “Hip Arthroplasty” (Churchill Livingstone, New York, 1991) p. 295.

    Google Scholar 

  3. D. Mcminn, R. Treacy, K. Lin and P. Pynsent, Clin. Orthop. 329Suppl (1996) S89.

    Google Scholar 

  4. Y. Gerard, ibid. 134 (1978) 25.

    Google Scholar 

  5. C. Trentani and F. Vaccarino, ibid. 134 (1978) 36.

    Google Scholar 

  6. K. Furuya, M. Tsuchiya and S. Kawachi, ibid. 134 (1978) 41.

    Google Scholar 

  7. A. Nishio, M. Eguchi and N. Kaibara, ibid. 134 (1978) 53.

    Google Scholar 

  8. W. N. Capello, P. H. Ireland, T. R. Trammell and P. Eicher, ibid. 134 (1978) 59.

    Google Scholar 

  9. M. Salzer, K. Knahr, H. Locke and N. Stark, ibid. 134 (1978) 80.

    Google Scholar 

  10. H. C. Amstutz, A. Graff-Radford, T. A. Gruen and I. C. Clarke, ibid. 134 (1978) 87.

    Google Scholar 

  11. H. Wagner, ibid. 134 (1978) 102.

    Google Scholar 

  12. W. H. Day, A. V. Swanson and M. R. Freeman, J. Bone Joint Surg. 57-B (1975) 302.

    Google Scholar 

  13. W. N. Capello, G. W. Misamore and T. M. Trancik, J. Bone Joint Surg. [Am.] 66 (1984) 518.

    Google Scholar 

  14. W. N. Capello, T. M. Trancik, G. Misamore and R. Eaton, Clin. Orthop. 170 (1982) 50.

    Google Scholar 

  15. M. A. Freeman, H. U. Cameron and G. C. Brown, ibid. 134 (1978) 45.

    Google Scholar 

  16. W. C. Head, J. Bone Joint Surg. [Am.] 63 (1981) 420.

    Google Scholar 

  17. R. S. Bell, J. Schatzker, V. L. Fornasier and S. B. Goodman, ibid. 67 (1985) 1165.

    Google Scholar 

  18. W. C. Kim, T. Grogan, H. C. Amstutz and F. Dorey, Clin. Orthop. 214 (1987) 269.

    Google Scholar 

  19. D. W. Howie, D. Campbell, M. Mcgee and B. L. Cornish, J. Bone Joint Surg. [Am.] 72 (1990) 708.

    Google Scholar 

  20. M. E. Steinberg, Orthop. Clin. North Am. 13 (1982) 895.

    Google Scholar 

  21. H. C. Amstutz and P. Grigoris, Clin. Orthop. 329Suppl (1996) S11.

    Google Scholar 

  22. G. K. Mckee and J. Watson-Farrar, J. Bone Joint Surg. [Br.] 48 (1966) 245.

    Google Scholar 

  23. F. P. Patterson and C. S. Brown, J. Bone Joint Surg. [Am.] 54 (1972) 257.

    Google Scholar 

  24. B. G. Weber, Clin. Orthop. 329Suppl (1996) S69.

    Google Scholar 

  25. M. Wagner and H. Wagner, ibid. 329Suppl (1996) S78.

    Google Scholar 

  26. I. C. Clarke, V. Good, P. Williams, D. Schroeder, L. Anissian, A. Stark, H. Oonishi, J. Schuldies and G. Gustafson, Proc. Inst. Mech. Eng. 214 (2000) 331.

    Google Scholar 

  27. W. H. Harris, Clin. Orthop. 311 (1995) 46.

    Google Scholar 

  28. M. E. Muller, ibid. 311 (1995) 54.

    Google Scholar 

  29. M. Bohler, Y. Mochida, T. W. Bauer, H. J. Plenk and M. Salzer, J. Bone Joint Surg. [Br.] 82 (2000) 901.

    Google Scholar 

  30. L. M. Jazrawi, F. J. Kummer and P. E. Dicesare, J. Am. Acad. Orthop. Surg. 6 (1998) 198.

    Google Scholar 

  31. P. F. Doorn, J. M. Mirra, P. A. Campbell and H. C. Amstutz, Clin. Orthop. 329Suppl (1996) S187.

    Google Scholar 

  32. H. G. Willert, G. Buchorn, A. Fayaayazi and C. Lohmann, Osteologie 9 (2000) 2.

    Google Scholar 

  33. P. Cambell, J. Mirra and I. Catelas, in “Transactions of the Society for Biomaterials”, (2002) p. 229.

  34. R. M. Urban, J. J. Jacobs, J. L. Gilbert and J. O. Galante, J. Bone Joint Surg. 76-A (1994) 1345.

    Google Scholar 

  35. M. F. Basle, G. Bertrand, S. Guyetant, D. Chappard and M. Lesourd, J. Biomed. Mater. Res. 30 (1996) 157.

    Google Scholar 

  36. P. Cambell and R. Urban, Unpublished work, (2001)

  37. N. Bohler, Orthopedics 18 (1995) 879.

    Google Scholar 

  38. J. B. Medley, J. M. Dowling, R. A. Poggie, J. J. Krygier and J. D. Bobyn, in “Alternative Bearing Surfaces in Total Joint Replacement, ASTM STP 1346” (American Society for Testing Materials, 1998) p. 92.

  39. P. S. Walker and G. W. Blunn, J. Arthroplasty 13 (1998) 339.

    Google Scholar 

  40. M. Schmidt, H. Weber and R. Schon, Clin. Orthop. 329Suppl (1996) S35.

    Google Scholar 

  41. J. J. Jacobs, A. K. Skipor, P. F. Doorn, P. Campbell, T. P. Schmalzried, J. Black and H. C. Amstutz, ibid. 329Suppl (1996) S256.

    Google Scholar 

  42. J. Karrholm, W. Frech, F. Snorrason and K. G. Nilsson, in “Transactions of the 39th Annual Meeting Orthopedic Research Society” (1993) 507.

  43. J. J. Jacobs, A. K. Skipor, L. M. Patterson, N. J. Hallab, W. G. Paprosky, J. Black and J. O. Galante, J. Bone Joint Surg. [Am.] 80 (1998) 1447.

    Google Scholar 

  44. J. Karrholm, W. Frech, B. Nivbrant, H. Malchau, F. Snorrason and P. Herberts, Acta Orthop. Scand. 69 (1998) 369.

    Google Scholar 

  45. J. J. Jacobs, A. K. Skipor, J. Black, R. M. Urban and J. O. Galante, J. Bone Joint Surg. 73-A (1991) 1475.

    Google Scholar 

  46. D. N. Kreibich, C. G. Moran, H. T. Delves, T. D. Owen and I. M. Pinder, J. Bone Joint Surg. Br. 78 (1996) 18.

    Google Scholar 

  47. F. W. J. Sunderman, S. M. Hopfer, T. Swift, W. N. Rezuke, L. Ziebka, P. Highman, B. Edwards, M. Folcik and H. R. Gossing, J. Orthop. Res. 7 (1989) 307.

    Google Scholar 

  48. R. F. Coleman, J. Herrington and J. T. Scales, Br. Med. J. 1 (1973) 527.

    Google Scholar 

  49. U. E. Pazzaglia, C. Minoia, I. Gualtiero, C. Riccardi and L. Ceciliani, Acta Orthop. Scand. 57 (1986) 415.

    Google Scholar 

  50. K. H. Tager, in “Technical Principles, Design and Safety of Joint Implants” (Hogrefe and Huber, Seattle, 1994) p. 72.

    Google Scholar 

  51. W. Brodner, P. Bitzan, V. Meisinger, A. Kaider, F. Gottsauner-Wolf and R. Kotz, J. Bone Joint Surg. Br. 79 (1997) 316.

    Google Scholar 

  52. A. W. Schaffer, A. Pilger, C. Engelhardt, K. Zweymueller and H. W. Ruediger, J. Toxicol. Clin. Toxicol. 37 (1999) 839.

    Google Scholar 

  53. V. Gleizes, J. Poupon, J. Y. Lazennec, B. Chamberlin and G. Saillant, Rev. Chir. Orthop. Reparatrice. Appar. Mot. 85 (1999) 217.

    Google Scholar 

  54. H. P. Sieber, C. B. Rieker and P. Kottig, J. Bone Joint Surg. Br. 81 (1999) 46.

    Google Scholar 

  55. H. Mckellop, H. Amstutz, B. L. I. Timmerman and M. Carroll in “Transactions of the Society for Biomaterials”, (2001) 339.

  56. P. F. Doorn, P. A. Campbell and H. C. Amstutz, Clin. Orthop. 329Suppl (1996) S206.

    Google Scholar 

  57. “2000 TLVs and BEIs. Threshold Limit Values for Chemical Substances and Physical Agents and Biological Exposure Indices” (American Conference of Governmental Industrial Hygienists, 2000).

  58. “IARC Monograph on the Evaluation of Carcinogenic Risks to Humans. Vol 74: Surgical Implants and Other Foreign Bodies” (World Health Organization Lyon, France 1999).

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, St. Luke's Medical Center, Room 756, Cohn Research Building, Rush Presbyterian, 1735 West Harrison St., Chicago, IL, 60612-3833, USA

    Anastasia K. Skipor, Leslie M. Patterson & Joshua J. Jacobs

  2. Orthopedic Hospital, Joint Replacement Institute, Los Angeles, CA, USA

    Patricia A. Campbell, Harlan C. Anstutz & Thomas P. Schmalzried

Authors
  1. Anastasia K. Skipor
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Patricia A. Campbell
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Leslie M. Patterson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Harlan C. Anstutz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Thomas P. Schmalzried
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Joshua J. Jacobs
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Skipor, A.K., Campbell, P.A., Patterson, L.M. et al. Serum and urine metal levels in patients with metal-on-metal surface arthroplasty. Journal of Materials Science: Materials in Medicine 13, 1227–1234 (2002). https://doi.org/10.1023/A:1021179029640

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1021179029640

Keywords

Search

Navigation