Immune responses correlate with serum-metal in metal-on-metal hip arthroplasty

Hallab, Nadim J.; Anderson, Shelley; Caicedo, Marco S.; Skipor, Anastasia K.; Campbell, Pat; Jacobs, Joshua J.

doi:10.1016/j.arth.2004.09.012

Cited by 114 publications

(89 citation statements)

References 15 publications

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“…Lastly, we wanted to explore the relationship among serum, erythrocyte, and urine ion levels. Like other studies, we found cobalt and chromium ion levels increased for patients with a metal-on-metal bearing [1,2,4,12,14,18,22]. However, the 2-year ion levels were as low or lower than most reports, likely indicating a bearing surface that is performing as well as others.…”

Section: Discussioncontrasting

confidence: 52%

“…With the metalon-metal bearings analyzed in this study, there was no increase in the erythrocyte chromium and a 5.6-to 9.6-fold increase in the urine chromium. Serum ion levels have been more commonly reported than erythrocyte ion levels [1,2,4,12,14,18,22]. Median serum cobalt levels have ranged from 0.7 lg/L to 3 lg/L in various studies [1,2,4,12,14,18,22].…”

Section: Discussionmentioning

confidence: 99%

“…However, measurement of ion levels from patients may allow an early glimpse of metal-on-metal bearing performance [17]. To date, variations in metal ion levels have been associated with head size, cup abduction angle, T cell counts, and lymphocyte changes [2,4,12,13,22]. In addition, a variation in ion levels reported in different studies has been attributed to design differences such The institution of one or more of the authors (CAE Jr, SS, CAE) has received funding from Inova Health Services (Fairfax, VA).…”

Section: Introductionmentioning

confidence: 99%

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2008 John Charnley Award: Metal Ion Levels After Metal-on-Metal Total Hip Arthroplasty: A Randomized Trial

MacDonald

Sritulanondha

Thompson

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Metal-on-metal bearing total hip arthroplasty is performed more commonly than in the past. There may be manufacturing differences such as clearance, roughness, metallurgy, and head size that affect performance. In a prospective, randomized trial, we compared 2-year postoperative ion levels for a 28-mm metal-on-polyethylene bearing with 28-mm and 36-mm metal-on-metal bearings. We measured serum, erythrocyte, and urine ion levels. We observed no difference in the ion levels for the 28-mm and 36-mm metal-on-metal bearings. The ion levels in these patients were lower than reported for most other metal-onmetal bearings. Although both erythrocyte and serum cobalt increased, erythrocyte chromium and erythrocyte titanium did not increase despite a four-to sixfold serum chromium and a three-to fourfold serum titanium increase. This may represent a threshold level for serum chromium and serum titanium below which erythrocytes are not affected.

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Section: Discussioncontrasting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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2008 John Charnley Award: Metal Ion Levels After Metal-on-Metal Total Hip Arthroplasty: A Randomized Trial

MacDonald

Sritulanondha

Thompson

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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“…There is ongoing concern regarding cellular toxicity [17,32,50], Type IV hypersensitivity reactions [18,45,55], and altered immunoregulatory mechanisms [26,27,30,31] resulting from chronic systemic elevations of metal ions in this patient population. Metal ions can generate the formation of free radicals [52].…”

Section: Discussionmentioning

confidence: 99%

Femoral Head Size Does Not Affect Ion Values in Metal-on-Metal Total Hips

Bernstein

Walsh

Petit

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Metal-on-metal articulations can release substantial amounts of particles containing cobalt and chromium into the surrounding milieu, causing concern for cellular toxicity and adverse local soft tissue reactions. The diameter of the femoral head has been one of the variables that inversely affects wear of metal-on-metal total hip arthroplasty (THA). The oxidative stress of increased metal ions can be measured with serum markers. It is still controversial if larger femoral head diameters decrease wear rates in patients with metal-on-metal THA and if the increased metal ions alter the body's antioxidant status.Questions/purposes We therefore (1) determined whole blood metal ions in patients with small (28 mm and 36 mm) and large (40 mm and 44 mm) diameter femoral heads; (2) measured oxidative stress markers (total antioxidants, nitrotyrosine, and peroxides); and (3) determined whether acetabular version or inclination influenced ion levels. Methods One hundred four patients were retrospectively studied. We recorded Harris hip scores and UCLA activity scores. All patients were followed at 1 year. Results The activity scores were similar in the two groups. There was no difference in metal ion levels or oxidative stress markers between patients with small-or large-diameter femoral heads. Acetabular inclination and anteversion had no effect on the metal ion levels. Conclusions The data suggest there is no difference in ion values in patients with large or small metal-on-metal THA and the increased metal ions do not alter the oxidant status of the patient.

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“…Иммунологические механизмы остеорезорбции начали изучать в процессе быстрого внедрения в медицинскую практику технологии эндопротезирования в лечении дегенеративно-дистрофических и посттравматических заболеваний тазобедренного сустава [1][2][3][4]. Ранее исследовали резорбцию костной ткани на экспериментальных моделях или с использованием клеточных культур [5,6].…”

Section: Introductionunclassified

Changes in laboratory parameters of peripheral blood reflect cell and protein content of the immune system in bone resorption

Berdyugina

Berdugin

2017

BIOMED KHIM

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The aim of this study was to investigate dynamic changes in the laboratory parameters of peripheral blood, reflecting cellular and protein composition of the immune system in bone resorption. The study involved 108 patients with degenerative-dystrophic and posttraumatic disorders of the hip joint before and after joint replacement surgery. Half of the cases resulted in bone resorption. Dynamic monitoring was performed up to 7.5 years. It included flow cytometry (Coulter Epics XL, USA) and enzyme immunoassay to determine the amount of immunocompetent cells, immunoglobulin class M, A, G, E, cytokines, acute phase proteins (C-reactive protein, fibrinogen, albumin, ceruloplasmin, haptoglobin), parameters of neutrophil functional activity (lactoferrin cationic protein, myeloperoxidase, superoxide anion production). The results of the study revealed the leading role of haptoglobin, albumin, and IL-1b in bone resorption. The use of multiple regression analysis made it possible to propose criteria for prediction of bone resorption. In particular, the Ig G concentration one month after operation at a value of 13 or less g/l with a probability of 86.8% suggests a high risk of bone tissue destruction in the operated area of the joint (diagnostic sensitivity and diagnostic specificity of 85.7% and 86.9%, respectively). Determination of the IL-1b level also has a good predictive power: its concentration exceeding 191.2 pg/ml six month after surgery with the probability of 87.4% suggests destruction of bone tissue in the operated area of the joint (diagnostic sensitivity and diagnostic specificity of 87.2% and 88.1%, respectively).

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Immune responses correlate with serum-metal in metal-on-metal hip arthroplasty

Cited by 114 publications

References 15 publications

2008 John Charnley Award: Metal Ion Levels After Metal-on-Metal Total Hip Arthroplasty: A Randomized Trial

2008 John Charnley Award: Metal Ion Levels After Metal-on-Metal Total Hip Arthroplasty: A Randomized Trial

Femoral Head Size Does Not Affect Ion Values in Metal-on-Metal Total Hips

Changes in laboratory parameters of peripheral blood reflect cell and protein content of the immune system in bone resorption

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