Hair sampling for chromium content following Charnley hip arthroplasty

The chromium content of hair has been studied by neutron activation analysis of samples from 62 patients following a Charnley unilateral or bilateral hip arthroplasty by an artificial joint of stainless steel against polyethylene, inserted three to five years previously. The patients lived in the North Wales area of the British Isles. Hair chromium content was also studied in 51 control subjects of similar age to that of the patients, from the same geographical area and often from the patients' own households. Chromium content was recorded as parts per million (ppm) of hair weighed and analyzed in the state received, without preliminary ashing or chemical "washing" of the samples in the laboratory. Fifty of the 51 control subjects showed less than 2 ppm chromium in hair; one showed 2-5 ppm; none showed more than 5 ppm. Fifty-nine of the 62 patients showed less than 2 ppm chromium in hair; three showed 2-5 ppm; none showed more than 5 ppm. Attention is drawn to certain practical aspects when collecting hair samples for chromium analysis. The use and validity of hair sampling as one method of screening for systemic chromium accumulation following implant surgery is discussed. The method may be a useful adjunct to monitoring of chromium levels in blood samples. In this preliminary study, hair sampling has given no evidence of any major risk of systemic chromium accumulation in patients using a Charnley arthroplasty for periods of up to five years; no conclusion can be made concerning periods longer than this. The findings do not exclude systemic reactions of the hypersensitivity type, since this type of reaction could develop to only small amounts of chromium.