title: Metal Ion Concentrations in Young, Active Patients Following Total Hip Arthroplasty with the Use of Modern Bearing Couples.
abstract: The purpose of this study was to compare whole blood metal ion levels in young, active patients undergoing primary total hip arthroplasty with the use of a cobalt-alloy (ten patients), ceramic (15 patients), or oxinium (11 patients) femoral head and highly crosslinked polyethylene acetabular liner. At 2 years postoperatively, mean cobalt concentrations were 3.0 times higher in the cobalt-alloy cohort versus the ceramic cohort, and 2.3 times higher versus the oxinium cohort (P=0.3-0.5). Titanium levels were consistently elevated at all postoperative time points versus preoperatively in all cohorts. Young, active patients following THA demonstrate elevated cobalt and titanium concentrations. Use of a ceramic or oxinium femoral head decreased the degree of cobalt elevation versus a cobalt-alloy femoral head, but did not reach statistical significance.
authors.affiliation: Washington University School of Medicine/Barnes-Jewish Hospital, Department of Orthopedic Surgery, St. Louis, Missouri.
authors.forename: Denis
authors.initials: D
authors.lastname: Nam
authors.affiliation: University of Missouri, Department of Orthopedic Surgery, Columbia, Missouri.
authors.forename: James A
authors.initials: JA
authors.lastname: Keeney
authors.affiliation: Washington University School of Medicine/Barnes-Jewish Hospital, Department of Orthopedic Surgery, St. Louis, Missouri.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Nunley
authors.affiliation: Washington University School of Medicine/Barnes-Jewish Hospital, Department of Orthopedic Surgery, St. Louis, Missouri.
authors.forename: Staci R
authors.initials: SR
authors.lastname: Johnson
authors.affiliation: Washington University School of Medicine/Barnes-Jewish Hospital, Department of Orthopedic Surgery, St. Louis, Missouri.
authors.forename: John C
authors.initials: JC
authors.lastname: Clohisy
authors.affiliation: Washington University School of Medicine/Barnes-Jewish Hospital, Department of Orthopedic Surgery, St. Louis, Missouri.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Barrack
mesh_terms: D000077:Acetabulum; D000328:Adult; D000497:Alloys; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D002516:Ceramics; D002857:Chromium / Q000097:blood*; D003035:Cobalt / Q000097:blood*; D005260:Female; D005270:Femur Head; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D020959:Polyethylene; D011184:Postoperative Period; D011446:Prospective Studies; D014025:Titanium / Q000097:blood*
chemical_list: D000497:Alloys; D008670:Metals; D002857:Chromium; D003035:Cobalt; D020959:Polyethylene; D014025:Titanium
keywords: ceramic; cobalt; metal ions; oxinium; total hip arthroplasty