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Clinical usefulness of blood metal measurements to assess the failure of metal-on-metal hip implants
In April 2010, a Medicines and Healthcare Products Regulatory Agency safety alert concerning all metal-on-metal (MOM) hip replacements recommended measuring chromium and cobalt concentrations when managing patients with painful prostheses. The need for this review is illustrated by the recent surge...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4527411/ https://www.ncbi.nlm.nih.gov/pubmed/22155921 http://dx.doi.org/10.1258/acb.2011.011141 |
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author | Sampson, Barry Hart, Alister |
author_facet | Sampson, Barry Hart, Alister |
author_sort | Sampson, Barry |
collection | PubMed |
description | In April 2010, a Medicines and Healthcare Products Regulatory Agency safety alert concerning all metal-on-metal (MOM) hip replacements recommended measuring chromium and cobalt concentrations when managing patients with painful prostheses. The need for this review is illustrated by the recent surge in requests for these blood tests from orthopaedic surgeons following this alert. The aim is to provide guidance to laboratories in assessing these requests and advising clinicians on interpretation. First, we summarize the basic terminology regarding the types of hip replacements, with emphasis on the MOM type. Second, we describe the clinical concerns over implant-derived wear debris in the local tissues and distant sites. Analytical aspects of the measurement of the relevant metal ions and what factors affect the levels measured are discussed. The application of inductively coupled plasma mass spectrometry techniques to the measurement of these metals is considered in detail. The biological effects of metal wear products are summarized with local toxicity and systemic biological effects considered, including carcinogenicity, genotoxicity and systemic toxicity. Clinical cases are used to illustrate pertinent points. |
format | Online Article Text |
id | pubmed-4527411 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-45274112015-08-12 Clinical usefulness of blood metal measurements to assess the failure of metal-on-metal hip implants Sampson, Barry Hart, Alister Ann Clin Biochem Review Articles In April 2010, a Medicines and Healthcare Products Regulatory Agency safety alert concerning all metal-on-metal (MOM) hip replacements recommended measuring chromium and cobalt concentrations when managing patients with painful prostheses. The need for this review is illustrated by the recent surge in requests for these blood tests from orthopaedic surgeons following this alert. The aim is to provide guidance to laboratories in assessing these requests and advising clinicians on interpretation. First, we summarize the basic terminology regarding the types of hip replacements, with emphasis on the MOM type. Second, we describe the clinical concerns over implant-derived wear debris in the local tissues and distant sites. Analytical aspects of the measurement of the relevant metal ions and what factors affect the levels measured are discussed. The application of inductively coupled plasma mass spectrometry techniques to the measurement of these metals is considered in detail. The biological effects of metal wear products are summarized with local toxicity and systemic biological effects considered, including carcinogenicity, genotoxicity and systemic toxicity. Clinical cases are used to illustrate pertinent points. SAGE Publications 2012-03 /pmc/articles/PMC4527411/ /pubmed/22155921 http://dx.doi.org/10.1258/acb.2011.011141 Text en © 2012 The Association for Clinical Biochemistry http://creativecommons.org/licenses/by-nc/3.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(http://www.uk.sagepub.com/aboutus/openaccess.htm). |
spellingShingle | Review Articles Sampson, Barry Hart, Alister Clinical usefulness of blood metal measurements to assess the failure of metal-on-metal hip implants |
title | Clinical usefulness of blood metal measurements to assess the failure of metal-on-metal hip implants |
title_full | Clinical usefulness of blood metal measurements to assess the failure of metal-on-metal hip implants |
title_fullStr | Clinical usefulness of blood metal measurements to assess the failure of metal-on-metal hip implants |
title_full_unstemmed | Clinical usefulness of blood metal measurements to assess the failure of metal-on-metal hip implants |
title_short | Clinical usefulness of blood metal measurements to assess the failure of metal-on-metal hip implants |
title_sort | clinical usefulness of blood metal measurements to assess the failure of metal-on-metal hip implants |
topic | Review Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4527411/ https://www.ncbi.nlm.nih.gov/pubmed/22155921 http://dx.doi.org/10.1258/acb.2011.011141 |
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