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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 5, 628-631.
doi: 10.1302/0301-620X.87B5.15384  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Metal ion levels after metal-on-metal proximal femoral replacements

A 30-YEAR FOLLOW-UP

E. Dunstan, FRCS Orth, Specialist Registrar1; A. P. Sanghrajka, MRCS, Research Fellow1; S. Tilley, MRCS, Senior House Officer1; P. Unwin, PhD, General Manager, Stanmore Implants Worldwide1; G. Blunn, PhD, Professor of Bio-Medical Engineering1; S. R. Cannon, FRCS, Consultant Orthopaedic Surgeon1; and T. W. R. Briggs, FRCS, Consultant Orthopaedic Surgeon1

1 Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.

Correspondence should be sent to Mr E. Dunstan at Ewelme, Harlow Road, Roydon, Essex CM19 5HH, UK; e-mail: erdunstan{at}aol.com

Metal-on-metal hip bearings are being implanted into younger patients. The consequence of elevated levels of potentially carcinogenic metal ions is therefore a cause for concern. We have determined the levels of cobalt (Co), chromium (Cr), titanium (Ti) and vanadium (Va) in the urine and whole blood of patients who had had metal-on-metal and metal-on-polyethylene articulations in situ for more than 30 years. We compared these with each other and with the levels for a control group of subjects.

We found significantly elevated levels of whole blood Ti, Va and urinary Cr in all arthroplasty groups. The whole blood and urine levels of Co were grossly elevated, by a factor of 50 and 300 times respectively in patients with loose metal-on-metal articulations when compared with the control group. Stable metal-on-metal articulations showed much lower levels. Elevated levels of whole blood or urinary Co may be useful in identifying metal-on-metal articulations which are loose.




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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General