Elevated serum cobalt with metal-on-metal articulating surfaces.
We determined serum cobalt levels in 55 patients by atomic absorption spectrophotometry before and after implantation of uncemented total hip arthroplasties. In a randomised, prospective trial 27 wrought Co-28Cr-6Mo-0.2C metal-on-metal articulations were compared with 28 ceramic-on-polyethylene hips which did not contain cobalt. Other sources of iatrogenic cobalt loading were excluded. The metal-on-metal group produced detectable serum cobalt levels (median 1.1 microg/l after one year) which were significantly different (p < 0.0001) from those of the ceramic-on-polyethylene control group (median below detection limit of 0.3 microg/l after one year). Our findings indicate that metal-on-metal bearings generate some systemic release of cobalt.
Brodner
W
W
Department of Occupational Medicine, University of Vienna, Austria.
Bitzan
P
P
Meisinger
V
V
Kaider
A
A
Gottsauner-Wolf
F
F
Kotz
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002516:Ceramics; D002858:Chromium Alloys; D003035:Cobalt / Q000097:blood*; D005260:Female; D006622:Hip Prosthesis / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011095:Polyethylenes; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D013054:Spectrophotometry, Atomic / Q000706:statistics & numerical data
D002858:Chromium Alloys; D011095:Polyethylenes; D003035:Cobalt