Abstract
Background: Recent clinical studies have suggested that systemic metal ion levels are significantly elevated at midterm follow-up in patients with ceramic-on-metal (COM) bearing. However, it is not clear whether there is a correlation between patient-related factors including the lifestyle and elevated levels of serum metal ions following COM total hip arthroplasty (THA). Methods: Serum metal levels were measured in 201 patients (234 hips) including 121 COM patients (140 hips) and 80 non-COM patients (94 hips). The Harris Hip Score, University of California, Los Angeles activity scale score, and Western Ontario and McMaster Universities Osteoarthritis Index score were measured and radiographs were obtained for the analysis. Results: Significantly higher levels of cobalt (Co) and chromium (Cr) were detected in the serum of the COM THA group (Co: 1.86 ± 4.0 μg/L; Cr: 1.81 ± 2.87 μg/L) than those of the non-COM THA group (Co: 0.27 ± 0.14 μg/L; Cr: 0.19 ± 0.25 μg/L; P <.001). The serum metal levels of patients who achieved the squatting position and the kneeling position were significantly higher than those of patients who could not squat (Co: P =.033; Cr: P =.074) and kneel (Co: P =.049; Cr: P =.031). The metal ion levels of the COM THA group correlated with the total range of motion (Co: P =.0293; Cr: P =.0399). Conclusion: Patients who underwent a 36-mm COM THA showed high serum metal levels although good clinical outcomes at the midterm follow-up. We found that COM THA patients who were capable of greater range of motion, squatting, and kneeling are at risk of metal ion–related problems.
Original language | English |
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Pages (from-to) | 887-892 |
Number of pages | 6 |
Journal | Journal of Arthroplasty |
Volume | 33 |
Issue number | 3 |
DOIs | |
Publication status | Published - 2018 Mar |
Bibliographical note
Funding Information:Funding: This research was funded by Johnson & Johnson Medical North Asia.
Funding Information:
We thank Green-Cross Co, Korea, for their support in the serum metal ion analysis and Professor Soon-Young Hwang, PhD (Biostatistical Consulting Lab. Medical Science Research Center, College of Medicine, Korea University, Seoul, Republic of Korea), for his statistical analysis and discussions. The authors would like to thank Professor Ian C Clarke for proofreading of the manuscript. This research was funded by Johnson & Johnson Medical North Asia.
Publisher Copyright:
© 2017 Elsevier Inc.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
Keywords
- Prognostic study
- ceramic
- level III
- lifestyle
- metal
- serum ion
- total hip arthroplasty
ASJC Scopus subject areas
- Orthopedics and Sports Medicine