Clinical Efficacy and Serum Cobalt, Chromium Metal Ion Concentrations after Total Hip Arthroplasty with Three Different Hard-on-Hard Bearings

CHENG Xing-wang, SHEN Bin , ZHENG Bo, YANG Jing, ZHOU Zong-ke, KANG Peng-de, PEI Fu-xing

Abstract

To compare the clinical efficacy and serum concentrations of cobalt, chromium metal ion in three different hard-on-hard bearings after total hip arthroplasty at 2-years postoperatively. Methods Ninety (90) ТНЛ patients were divided into ceramic-on-ceramic (COC)* ceramic-on-metal (COM), metal-on-metal (MOM) group (// = 30 in each group). At preoperative and 3, 6, 12, 24 months postoperative 5 time points, serum concentrations of cobalt and chromium metal ion were measured, Harris hip score was evaluated, X-rays and color doppler ultrasound examination of the ipsilateral hip also were observed. Results The excellent rates of Harris hip score were 100% in three groups. Continuous X-rays showed no radiolucent line around the acetabular component, no osteolysis, and no inflammatory pseudotumor. After the THA operation, the metal ion levels in COM and MOM groups increased rapidly, and stabilized at 12 months, then showed a downward trend, but the chromium ion level of MOM continued to rise at 24 months, with a significant difference when compared with that at 12 months (an increase of 0. 48 /*g/L, P—0. 021). The serum concentrations of metal ion in COC group were relatively constant at all time points, and the cobalt, chromium ion levels of MOM group were significantly higher than those of COC and COM group. Conclusion The postoperative functional recovery of the three hard-on-hard bearings all were good, and no inflammatory pseudotumor and osteolysis were found. The serum levels of cobalt, chromium ion of COM were lower than those of MOM, but higher than those of COC.

 

Keywords: Total hip arthroplasty, Metal ion, Ceramic-on-metal, Inflammatory pseudotumor


Full Text:

PDF


References


Flugsrud GB. Nordsletten L. Espehaug B, et al. The impact of body mass index on later total hip arthroplasty for primary osteoarthritis; a cohort study in 1.2 million persons. Arthritis Rheum. 2006; 54 (3); 802-807.

Lewinnek GE, Lewis JL, Tarr R. et al. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am, 1978;60(2):217-220.

Zweymuller КА, Schwarzinger UM, Steindl MS. et al. Radiolucent lines and osteolysis along tapered straight cementless titanium hip stems; a comparison of 6-year and 10- year follow-up results in 95 patients. Acta Orthop, 2006; 77 (6):871-876.

Pradhan R. Planar anteversion of the acetabular cup as determined from plain anteroposteriorradiographs. J Bone Joint Surg(Br), 1999 ;81(3) : 431-435.

Valenti JR. Del RJ. Amillo S. Catastrophic wear in a metal-on- ceramic total hip arthroplasty. J Arthroplasty. 2007; 22 ( 6 ): 920-922.

Williams S. Brockett CL. Hardaker C. et al. Novel ceramic- on-metal hip replacements. J Bone Joint Surg( Br), 2011; 93B ( suppl 1) : 35.

Migaud H, Putman S. Krantz N, et al. Cementless metal-on- metal versus ceramic-on-polyethylene hip arthroplasty in patients less than fifty years of age; a comparative study with twelve to fourteen-year follow-up. J Bone Joint Surg Am, 2011;93(suppl 2); 137-142.

Hananouchi T, Saito M, Nakamura N. Huge pelvic mass secondary to wear debris causing ureteral obstruction. J Arthroplasty, 2005; 20(7): 946-949.

Williams S, Schepers A, Isaac G, et al. The 2007 Otto Aufranc Award: ceramic-on-metal hip arthroplasties: a comparative in vitro and in vivo study. Clin Orthop Relat Res, 2007;46(5) :23-32.

Back DL, Young DA, Shimmin AJ. How do serum cobalt and chromium levels change after metal-on-metal hip resurfacing. Clin Orthop Relat Res,2005;438(9): 177-181.

Maezawa K. Nozawa M, Yuasa T, et al. Changes of serum chromium levels after Metasul metal-on-metal total hip arthroplasty. J Arthroplasty,2010;25(8); 1196-1200.


Refbacks

  • There are currently no refbacks.