title: Serum aluminium and cobalt levels after ceramic-on-ceramic and metal-on-metal total hip replacement.
abstract: In a randomised study, 28 patients with a mean age of 62.2 years (32 to 81) with osteoarthritis or avascular necrosis of the hip received either a ceramic-on-ceramic or a metal-on-metal total hip replacement. Apart from the liners the acetabular and femoral components were made of Ti-Al-Nb alloy. The serum aluminium and cobalt levels were measured before, and at one year after surgery. The 15 patients in the ceramic-on-ceramic group had a median pre-operative aluminium level of 1.3 microg/l (0.25 to 8.4) and a cobalt level below the detection limit. At one year the aluminium level was 1.1 microg/l (0.25 to 2.3) and the cobalt level was 0.4 microg/l (0.15 to 0.7). The 13 patients in the metal-on-metal group had a median pre-operative aluminium level of 1.9 microg/l (0.25 to 4.4) and a cobalt level below the detection limit. At one year the median aluminium level was 0.9 microg/l (0.25 to 3.9) whereas the cobalt level was 1.4 microg/l (0.5 to 10.5). This increase in the cobalt level at one year was significant (p < 0.001). Our findings indicate that ceramic-on-ceramic bearings do not cause elevated levels of serum aluminium in the first post-operative year.
authors.affiliation: Department of Orthopaedics, Medical University of Vienna Austria. alexander.gruebl@meduniwien.ac.at
authors.forename: A
authors.initials: A
authors.lastname: Grübl
authors.forename: M
authors.initials: M
authors.lastname: Weissinger
authors.forename: W
authors.initials: W
authors.lastname: Brodner
authors.forename: A
authors.initials: A
authors.lastname: Gleiss
authors.forename: A
authors.initials: A
authors.lastname: Giurea
authors.forename: M
authors.initials: M
authors.lastname: Gruber
authors.forename: G
authors.initials: G
authors.lastname: Pöll
authors.forename: V
authors.initials: V
authors.lastname: Meisinger
authors.forename: F
authors.initials: F
authors.lastname: Gottsauner-Wolf
authors.forename: R
authors.initials: R
authors.lastname: Kotz
mesh_terms: D000077:Acetabulum / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000535:Aluminum / Q000097:blood*; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods; D002516:Ceramics; D003035:Cobalt / Q000097:blood*; D005260:Female; D005269:Femur / Q000601:surgery; D005271:Femur Head Necrosis / Q000097:blood / Q000601:surgery; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D010003:Osteoarthritis / Q000097:blood / Q000601:surgery; D011446:Prospective Studies; D011474:Prosthesis Design; D016896:Treatment Outcome
chemical_list: D008670:Metals; D003035:Cobalt; D000535:Aluminum