|
KMID : 0386720030150030200
|
|
Journal of the Korean Hip Society
2003 Volume.15 No. 3 p.200 ~ p.208
|
|
|
Increased Serum Cobalt Levels with Metal on Metal Articulation Surfaces
|
|
Kim Young-Ho
Park Ki-Chul
Kim Yee-Suk
Choi Il-Yong
|
|
|
Abstract
|
|
|
Purpose: This study was undertaken to find if metal on metal bearings release detectable levels of cobalt into the serum compared to ceramic on polyethylene bearings, and to identify the factors influencing elevated serum cobalt levels.
Materials and Methods: The serum cobalt levels in forty-seven patients were determined before and after the implantation of cementless total hip arthroplasties with hydroxyapatite CLS stems. In a randomized, prospective trial, 24 metal on metal articulations were compared with twenty-three non-cobalt containing ceramic on polyethylene articulations. Other sources of iatrogenic cobalt loading were excluded. Blood samples were, taken preoperatively, at three and six weeks, three and six months and at one year after surgery. The cobalt levels were determined using atomic absorption spectrophotometry (ETV-ICP-MS). (Eds note: ICP is an atomic emission method, not absorption?)
Results: The mean serum cobalt levels in the ceramic on polyethylene group were 0.064, 0.068, 0.069, 0.070, 0.072 and 0.077Erg/ I , preoperatively, at 3 and 6 weeks, 3 and 6 months, and at 1 year, respectively. Those in the metal on metal group were 0.076, 1.414, 1.678, 1.653, 2.133 and 2.704 Erg/
l , preoperatively, at 3 and 6 weeks, at 3 and 6 month, and at 1 year, respectively, which were significantly higher compared to the ceramic on polyethylene group (p<0.05). The serum cobalt levels in the metal on metal group increased with time, and were significantly affected by the patient activity 1 year postoperatively (p=0.025).
Conclusion: The serum cobalt levels in the metal on metal group were significantly higher compared to those of the ceramic on polyethylene group, and increased with time and were significantly elevated by the patient activity 1 year postoperatively. Further investigation of the serum cobalt levels after more than 1 year are mandatory due to long term effects of an increased serum cobalt level.
|
|
|
KEYWORD
|
|
|
Metal on metal articulation, Total hip arthroplasty, Serum cobalt level
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
 
|
|