Serum ion level after metal-on-metal THA in patients with renal failure.
We retrospectively reviewed cementless THAs with metal-on-metal bearings in five patients with chronic renal failure and investigated the relations between renal failure and elevated serum cobalt and chromium levels and the side effects of these elevations. Serum cobalt and chromium levels were measured by atomic absorption spectrophotometry at a minimum followup of 2.7 years (mean, 3.9 years; range, 2.7-6.2 years) in five patients with chronic renal failure and in six patients with normal renal function after THA. Mean serum cobalt concentration was 12.5 microg/L in patients with chronic renal failure; this was more than 100-fold higher than in patients with the same prosthesis type and similar followup period, but with no known renal disease. However, the mean serum chromium concentration was 5.1 microg/L, which was within the normal range in all 11 study patients. Side effects related to elevation of serum cobalt or serum chromium concentration were not identified and overall clinical results were good 4 years after surgery. The serum cobalt level was higher in patients with chronic renal failure. Longer followup is necessary to determine any clinical effects.
Hur
Chang Ich
CI
Department of Orthopaedics, Center for Joint Disease, Chonnam National University Hwasun Hospital, Chonnam National University School of Medicine, 160 Ilsimri, Hwasun-eup, Hwasun-gun, Hwasun, Jeonnam, Korea.
Yoon
Taek Rim
TR
Cho
Sang Gwon
SG
Song
Eun Kyoo
EK
Seon
Jong Keun
JK
D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation*; D002857:Chromium / Q000009:adverse effects / Q000097:blood*; D003035:Cobalt / Q000009:adverse effects / Q000097:blood*; D005260:Female; D005265:Femoral Neck Fractures / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D010020:Osteonecrosis / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D018579:Patient Selection; D011474:Prosthesis Design; D011859:Radiography; D012189:Retrospective Studies; D013054:Spectrophotometry, Atomic; D013997:Time Factors; D016896:Treatment Outcome
D002857:Chromium; D003035:Cobalt