title: Serum metal ion concentrations in paediatric patients following total knee arthroplasty using megaprostheses.
abstract: The purpose of this study was to determine the concentrations of cobalt, chromium, and molybdenum in the serum of paediatric tumour patients after fixed hinge total knee arthroplasty. Further, these metal ion levels were compared with serum metal ion levels of patients with other orthopaedic devices such as hip and knee prostheses with metal-on-metal or metal-on-polyethylene articulation to find differences between anatomical locations, abrasion characteristics, and bearing surfaces. After an average follow-up of 108 months (range: 67 to 163) of 11 paediatric patients with fixed hinge total knee arthroplasty, the mean concentrations for Co and Cr were significantly increased while Mo was within the limits compared to the upper values from the reference laboratory. Furthermore, these serum concentrations were significantly higher compared to patients with a standard rotating hinge device (P = 0.002 and P < 0.001) and preoperative controls (P < 0.001). On the other hand, the serum levels of patients following MoM THA or rotating hinge arthroplasty using megaprostheses were higher. Therefore, periodic long-term follow-ups are recommended due to the rising concerns about systemic metal ion exposure in the literature. Upon the occurrence of adverse reactions to metal debris the revision of the fixed hinge implant should be considered.
authors.affiliation: Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria.
authors.forename: Jörg
authors.initials: J
authors.lastname: Friesenbichler
authors.affiliation: Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria.
authors.forename: Patrick
authors.initials: P
authors.lastname: Sadoghi
authors.affiliation: Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria.
authors.forename: Werner
authors.initials: W
authors.lastname: Maurer-Ertl
authors.affiliation: Department of Oncology, University Clinic of Internal Medicine, Medical University of Graz, Austria.
authors.forename: Joanna
authors.initials: J
authors.lastname: Szkandera
authors.affiliation: Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria.
authors.forename: Mathias
authors.initials: M
authors.lastname: Glehr
authors.affiliation: Institute for Forensic Medicine, Medical University of Graz, Austria.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Ogris
authors.affiliation: Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Wolf
authors.affiliation: Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Weger
authors.affiliation: Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Leithner
mesh_terms: D000293:Adolescent; D019645:Arthroplasty, Replacement, Knee; D016022:Case-Control Studies; D002648:Child; D003710:Demography; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D007477:Ions / Q000097:blood; D008297:Male; D008670:Metals / Q000097:blood*
chemical_list: D007477:Ions; D008670:Metals