This Article Full Text Full Text (PDF) Further opinion Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal My Folders Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (9) Citing Articles via Google Scholar Google Scholar Articles by Hart, A. J. Articles by Skinner, J. Search for Related Content PubMed PubMed Citation Articles by Hart, A. J. Articles by Skinner, J.

The association between metal ions from hip resurfacing and reduced T-cell counts

¹ Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, University College, London Campus, Middlesex, HA7 4LP, UK.
² MRC Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK.
³ Cell Cycle Laboratory, Cancer Research UK London Institute, 44 Lincoln’s Inn Fields, London WC2A 3PX, UK.

Correspondence should be sent to Mr A. J. Hart; e-mail: alisterjhart{at}yahoo.com.

We have studied the relationship between metal ion levels and lymphocyte counts in patients with metal-on-metal hip resurfacings. Peripheral blood samples were analysed for lymphocyte subtypes and whole blood cobalt and chromium ion levels in 68 patients (34 with metal-on-metal hip resurfacings and 34 with standard metal-on-polyethylene total hip replacements). All hip components were radiologically well-fixed and the patients were asymptomatic. Cobalt and chromium levels were significantly elevated in the patients with metal-on-metal hip resurfacings, compared with the patients with standard metal-on-polyethylene designs (p < 0.0001). There was a statistically significant decrease in the level of CD8⁺ cells (T-cytotoxic/suppressor) (p = 0.005) in the metal-on-metal hip resurfacing group. A threshold level of blood cobalt and chromium ions was associated with reduced CD8⁺ T-cell counts. We have no evidence that our patients suffered as a result of this reduced level of CD8⁺ T-cells.

This article has been cited by other articles:

				R. De Haan, C. Pattyn, H. S. Gill, D. W. Murray, P. A. Campbell, and K. De Smet Correlation between inclination of the acetabular component and metal ion levels in metal-on-metal hip resurfacing replacement J Bone Joint Surg Br, October 1, 2008; 90-B(10): 1291 - 1297. [Abstract] [Full Text] [PDF]

				L. Lidgren Chronic inflammation, joint replacement and malignant lymphoma J Bone Joint Surg Br, January 1, 2008; 90-B(1): 7 - 10. [Abstract] [Full Text] [PDF]

				H. A. Anwar, C. H. Aldam, S. Visuvanathan, and A. J. Hart The effect of metal ions in solution on bacterial growth compared with wear particles from hip replacements J Bone Joint Surg Br, December 1, 2007; 89-B(12): 1655 - 1659. [Abstract] [Full Text] [PDF]

				G. M. Keegan, I. D. Learmonth, and C. P. Case Orthopaedic metals and their potential toxicity in the arthroplasty patient: A REVIEW OF CURRENT KNOWLEDGE AND FUTURE STRATEGIES J Bone Joint Surg Br, May 1, 2007; 89-B(5): 567 - 573. [Abstract] [Full Text] [PDF]

				P. Sauve, J. Mountney, T. Khan, J. De Beer, B. Higgins, and M. Grover Metal ion levels after metal-on-metal Ring total hip replacement: A 30-YEAR FOLLOW-UP STUDY J Bone Joint Surg Br, May 1, 2007; 89-B(5): 586 - 590. [Abstract] [Full Text] [PDF]

				J. Daniel, H. Ziaee, C. Pradhan, P. B. Pynsent, and D. J. W. McMinn Blood and urine metal ion levels in young and active patients after Birmingham hip resurfacing arthroplasty: FOUR-YEAR RESULTS OF A PROSPECTIVE LONGITUDINAL STUDY J Bone Joint Surg Br, February 1, 2007; 89-B(2): 169 - 173. [Abstract] [Full Text] [PDF]