title: Clinical Results and Metal Ion Levels After Ceramic-on-Metal Total Hip Arthroplasty: A Mean 50-Month Prospective Single-Center Study.
abstract: BACKGROUND
  The aim of our study was to investigate the clinical results and serum metal ion levels in a cohort of patients who received total hip arthroplasty (THA) with ceramic-on-metal (CoM) bearings.
  
  
  METHODS
  From September 2009 to December 2011, 78 patients (89 hips) who underwent THA with CoM bearings were involved in this study. Harris Hip Score, Short-Form 12, and Western Ontario and McMaster Universities Osteoarthritis Index scores were measured and radiographs were taken for radiographic analysis. Serum metal ion levels of cobalt (Co), chromium (Cr), molybdenum (Mo), and titanium (Ti) were measured using high-resolution inductively coupled plasma-mass spectrometry.
  
  
  RESULTS
  Severy-four patients (85 hips) were followed up at a mean of 50 months. At the end of follow-up, HSS, Short-Form 12, and Western Ontario and McMaster Universities Osteoarthritis Index scores were improved significantly compared with preoperative values. No intraoperative and postoperative complications occurred, and no radiolucency, osteolysis, and loosening was found from radiographic examination. Metal ion analysis showed that serum metal ions levels were significantly elevated compared with normal values. Spearman correlation analysis revealed that there was a correlation between 3 metal ion levels and body mass index(Co: r = 0.49, P < .01; Cr: r = 0.47, P < .01; Mo: r = 0.36, P = .04). No correlation was found between metal ion levels and age, cup abduction angle, cup anteversion angle, acetabular version, bilateral arthroplasty, cup screw used, hip stem implant type, or femoral head size.
  
  
  CONCLUSIONS
  Our study concluded that the use of a CoM THA is effective clinically, but the systemic metal ion levels are significantly elevated at midterm follow-up. Whether the elevated metal ion levels will induce an adverse reaction is unknown and long-term follow-up is need.
authors.affiliation: Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Zeng
authors.initials: Z
authors.lastname: Yi
authors.affiliation: Analysis and Testing Center, West China School of Public Health, Sichuan Univeristy, Chengdu, Sichuan Province, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Bo
authors.affiliation: Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Shen
authors.initials: S
authors.lastname: Bin
authors.affiliation: Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Jing
authors.affiliation: Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Zhou
authors.initials: Z
authors.lastname: Zongke
authors.affiliation: Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Pei
authors.initials: P
authors.lastname: Fuxing
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D002516:Ceramics; D002857:Chromium / Q000097:blood; D003035:Cobalt / Q000097:blood; D005260:Female; D005271:Femur Head Necrosis / Q000601:surgery; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008670:Metals / Q000097:blood*; D008875:Middle Aged; D008982:Molybdenum / Q000097:blood; D011446:Prospective Studies; D011474:Prosthesis Design; D014025:Titanium / Q000097:blood; D055815:Young Adult
chemical_list: D008670:Metals; D002857:Chromium; D003035:Cobalt; D008982:Molybdenum; D014025:Titanium
keywords: ceramic-on-metal bearings; clinical function; follow-up study; metal ion level; total hip arthroplasty