Journal ArticleDOI
Sensitivity and specificity of blood cobalt and chromium metal ions for predicting failure of metal-on-metal hip replacement
Alister Hart,Shiraz A. Sabah,A. S. Bandi,P. Maggiore,P. Tarassoli,Barry Sampson,John A. Skinner +6 more
TLDR
Blood metal ions had good discriminant ability to separate failed from well-functioning hip replacements, and the MHRA cut-off level of 7 ppb provides a specific test but has poor sensitivity.Abstract:
Blood metal ions have been widely used to investigate
metal-on-metal hip replacements, but their ability to discriminate
between well-functioning and failed hips is not known. The Medicines
and Healthcare products Regulatory Agency (MHRA) has suggested a
cut-off level of 7 parts per billion (ppb). We performed a pair-matched, case-control study to investigate
the sensitivity and specificity of blood metal ion levels for diagnosing
failure in 176 patients with a unilateral metal-on-metal hip replacement.
We recruited 88 cases with a pre-revision, unexplained failed hip
and an equal number of matching controls with a well-functioning
hip. We investigated the 7 ppb cut-off level for the maximum of
cobalt or chromium and determined optimal mathematical cut-off levels
from receiver-operating characteristic curves. The 7 ppb cut-off level for the maximum of cobalt or chromium
had a specificity of 89% and sensitivity 52% for detecting a pre-operative
unexplained failed metal on metal hip replacement. The optimal cut-off
level for the maximum of cobalt or chromium was 4.97 ppb and had
sensitivity 63% and specificity 86%. Blood metal ions had good discriminant ability to separate failed
from well-functioning hip replacements. The MHRA cut-off level of
7 ppb provides a specific test but has poor sensitivity.read more
Citations
More filters
Journal ArticleDOI
Inductively Coupled Plasma Mass Spectrometry: Introduction to Analytical Aspects.
TL;DR: Clinical scientists should be aware of the analytical aspects of ICP-MS, as well as the potential for both spectroscopic and non-spectroscopic interference, and strategies that can be employed to eliminate or mitigate these issues.
Journal ArticleDOI
Corrosion at the neck-stem junction as a cause of metal ion release and pseudotumour formation
TL;DR: Dual modular cobalt-chrome hip prostheses should be used with caution due to concerns of corrosion at neck-stem tapers, which has been identified as an important source of metal ion release and pseudotumour formation requiring revision surgery.
Journal ArticleDOI
Potential release of in vivo trace metals from metallic medical implants in the human body: from ions to nanoparticles--a systematic analytical review.
TL;DR: An overview of analytical methods, techniques and different approaches applied to the measurement of in vivo trace metals released into body fluids and tissues from patients carrying metal-on-metal prostheses and metal dental implants is given.
Journal ArticleDOI
Molecular analysis of chromium and cobalt-related toxicity
Brian Scharf,Cristina C. Clement,Valerio Zolla,Giorgio Perino,Bo Yan,S. Gokhan Elci,E. Purdue,Steven R. Goldring,Frank P. Macaluso,Neil J. Cobelli,Richard W. Vachet,Laura Santambrogio +11 more
TL;DR: Analysis of the biological responses associated with Co and Cr toxicity reveals several biological mechanisms leading to tissue damage, necrosis, and inflammation in patients with Cr and Co-associated adverse local tissue reactions.
Journal ArticleDOI
Risk stratification algorithm for management of patients with metal-on-metal hip arthroplasty: consensus statement of the American Association of Hip and Knee Surgeons, the American Academy of Orthopaedic Surgeons, and the Hip Society
Young-Min Kwon,Adolph V. Lombardi,Joshua J. Jacobs,Thomas K. Fehring,Courtland G. Lewis,Miguel E. Cabanela +5 more
TL;DR: There should be a low threshold to perform a systematic evaluation of patients with MoM hip arthroplasty as early recognition and diagnosis will facilitate the initiation of appropriate treatment prior to significant adverse biological reactions.
References
More filters
Journal ArticleDOI
Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation
TL;DR: In this article, an end-result analysis is presented of thirty-nine mold arthroplasties performed at the Massachusetts General Hospital between 1945 and 1965 in thirty-eight consecutive private patients for arthritis of the hip following fractures of the acetabulum or dislocations.
MonographDOI
Introduction to Numerical Analysis
TL;DR: 1. The numerical evaluation of expressions 2. Linear systems of equations 3. Interpolation and numerical differentiation 4. Numerical integration 5. Univariate non linear equations 6. Systems of nonlinear equations.
Book
An introduction to numerical analysis
TL;DR: In this article, the authors present a solution to the Matrix Eigenvalue Problem for linear systems of linear equations, based on linear algebra and linear algebra with nonlinear functions, which they call linear algebraic integration.
Journal ArticleDOI
Questionnaire on the perceptions of patients about total hip replacement
TL;DR: In this article, a 12-item questionnaire for patients having a total knee replacement (TKR) was developed and a prospective study of 117 patients before operation and at follow-up six months later, asking them to complete the new questionnaire and the form SF36.
Journal ArticleDOI
Corrosion of metal orthopaedic implants.
TL;DR: This review focuses on electrochemical corrosion phenomena in alloys used for orthopaedic implants, evidenced by particulate corrosion and wear products in tissue surrounding the implant, which may ultimately result in a cascade of events leading to periprosthetic bone loss.