Measurement of titanium in hip-replacement patients by inductively coupled plasma optical emission spectroscopy

Abstract

Background Patients with metal-on-metal hip replacements require testing for cobalt and chromium. There may also be a need to test for titanium, which is used in the construction of the femoral stem in total hip replacements. It is not possible to use quadrupole inductively coupled plasma mass spectrometry due to interferences. Methods Titanium was measured using inductively coupled plasma optical emission spectroscopy using the emission line at 336.1 nm and Y (internal standard) at 371.0 nm. Internal quality control materials were prepared for blood and serum and concentrations assigned using a sector field-inductively coupled plasma mass spectrometer. A candidate whole blood certified reference material was also evaluated. Results The method had detection and quantitation limits of 0.6 and 1.9 µg/L, respectively. The respective bias (%) and measurement uncertainty ( U) (k = 2) were 3.3% and 2.0 µg/L (serum) and - 1.0% and 1.4 µg/L (whole blood). The respective repeatability and intermediate precision (%) were 5.1% and 10.9% (serum) and 2.4% and 8.6% (whole blood). The concentration of titanium was determined in patients' samples, serum (median = 2.4 µg/L, n = 897) and whole blood (median = 2.4 µg/L, n = 189). Serum is recommended for monitoring titanium in patients, since the concentration is higher than in whole blood and the matrix less problematic. In hip fluid samples, the concentrations were much higher (mean 58.5 µg/L, median 5.1 µg/L, n = 83). Conclusions A method based on inductively coupled plasma optical emission spectroscopy was developed and validated for measuring titanium in clinical samples.

Blood titanium level as a biomarker of orthopaedic implant wear

“…As a result, they are not widely available in routine clinical laboratories. Inductively coupled plasma optical emission spectroscopy (ICP-OES) could be a more practical and cost-effective solution [89]. The method displayed a low detection limit for the determination of titanium concentration in the serum (0.6 µg L -1 ) [89], plasma (1.6 µg L -1 ) [90] and periprosthetic tissue (3.0 µg g -1 ) [91] of patients with MoM hips.…”

Atomic spectrometry update: review of advances in the analysis of clinical and biological materials, foods and beverages

“…Examination of removed devices suggests that there are problems associated with the titanium alloy stem that goes into the femoral bone. Blood samples were collected from 39 subjects aged 18 to 74 years and 65 Cu : 63 Cu and 66 Zn : 64 Zn ratios measured, obtaining results that were consistent with the animal ndings. Determination of Ti by Q-ICP-MS is complicated by isobaric interferences from the relatively huge concentrations of Ca isotopes.…”

“…Fe Exhaled air ICP-MS As part of an investigation of potential biomarkers of exposure to welding fumes, the content of Fe and Mn in endogenous particles in exhaled air was determined by ICP-MS in samples collected from 9 individuals, experimentally exposed to welding fumes, revealing increased mean concentrations of Mn (82-84 pg L À1 ) and Fe (2600 pg L À1 ) in exhaled air Blood, plasma ICP-MS Mn concentrations were determined in blood and serum samples aer dilution with a solution of 0.005% Triton X-100-0.2% propan-2-ol-0.2% butan-1-ol-1% HNO 3 and addition of Ga as the internal standard. Several isotopes were monitored simultaneously ( 13 C, 111 Cd, 112 Cd, 114 Cd, 63 Cu, 56 Fe, 57 Fe, 31 P, 34 From starting conditions which completely digested 500 mg of sample (whole milk powder or bovine liver) using dilute HNO 3 and O 2 (7.5 or 5.0 bar), the authors optimised concentrations to give minimal residual carbon content (RCC) and residual acid (RA). Recovery of spiked amounts of all analytes at different concentration levels was >87% and RSDs were between 2% and 7%.…”

“…Harrington et al63 The use of collision reaction cell with ICP-MS is well established and has been used to solve a number of challenges.…”

Blood and plasma titanium levels associated with well-functioning hip implants

“…Titanium ions associate with plasma proteins [37], which accounts for the higher titanium 34 content of plasma compared to whole blood [38]. Serum/plasma sampling is preferred by 35 some researchers, because the higher titanium levels are easier to detect and quantify.…”