Cobalt and chromium levels in blood and urine following hip resurfacing arthroplasty with the Conserve Plus implant

J Bone Joint Surg Am. 2011 May:93 Suppl 2:107-17. doi: 10.2106/JBJS.J.01721.

Abstract

Background: The purpose of the present study was to determine cobalt and chromium ion levels in the blood and urine of patients in whom a modern-generation metal-on-metal hip resurfacing device had been implanted.

Methods: A total of ninety-seven patients with a Conserve Plus metal-on-metal hip resurfacing implant were followed prospectively for two years. Cobalt and chromium levels in erythrocytes, serum, and urine were measured preoperatively as well as three, six, twelve, and twenty-four months postoperatively.

Results: The median serum cobalt and chromium ion levels were 1.04 μg/L (range, 0.31 to 7.42 μg/L) and 2.00 μg/L (range, 0.28 to 10.49 μg/L), respectively, at one year after surgery and 1.08 μg/L (range, 0.44 to 7.13 μg/L) and 1.64 μg/L (range, 0.47 to 10.95 μg/L), respectively, at two years after surgery. The corresponding mean levels (and standard deviations) of serum cobalt and chromium were 1.68 ± 1.66 μg/L and 2.70 ± 2.22 μg/L, respectively, at one year after surgery and 1.79 ± 1.66 μg/L and 2.70 ± 2.37 μg/L, respectively, at two years after surgery.

Conclusions: These levels compare favorably with other published ion results for metal-on-metal hip resurfacing and replacement implants. No pseudotumors or other adverse soft-tissue reactions were encountered in our study population. Further research is needed to determine the clinical importance of increased cobalt and chromium ion levels in serum and urine following metal-on-metal hip resurfacing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Arthroplasty, Replacement, Hip / instrumentation*
  • Chromium / blood*
  • Chromium / urine*
  • Cobalt / blood*
  • Cobalt / urine*
  • Female
  • Hip Prosthesis*
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Design
  • Statistics, Nonparametric

Substances

  • Chromium
  • Cobalt