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Metal-on-metal hip implants: do they impair renal function in the long-term? A 10-year follow-up study
Martina Marker1, Alexander Grübl, Otto Riedl
1Department of Orthopaedics, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, Austria. martina.marker@gmx.net
Insights
Long-term follow-up of metal-on-metal hip implants shows no impact of elevated serum cobalt or chromium on kidney function. Renal function remains normal in patients 10 years post-surgery.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Nephrology
Background:
- Metal-on-metal hip implants can release cobalt and chromium ions.
- Concerns exist regarding potential long-term effects on renal function.
- Assessing renal health at a minimum of 10 years post-implantation is crucial.
Purpose of the Study:
- To investigate the influence of elevated serum cobalt and chromium levels on renal function.
- To evaluate kidney health in patients with metal-on-metal hip implants at least 10 years after surgery.
Main Methods:
- Study included 75 patients 10 years after receiving a metal-on-metal Metasul hip implant.
- Laboratory analysis included serum creatinine, complete blood count, and serum cobalt and chromium levels.
- Serum creatinine clearance (Ccr) was assessed.
Main Results:
- Median serum creatinine levels were within the normal range (0.86 mg/dl).
- Serum creatinine clearance (Ccr) was normal.
- Median serum cobalt and chromium levels were 0.75 microg/l and 0.95 microg/l, respectively.
- Hemogram results did not significantly change from baseline.
Conclusions:
- Long-term data indicate no adverse effect of serum cobalt or chromium on renal function.
- Total hip arthroplasty with metal-on-metal bearings did not compromise kidney health at 10 years.
- Elevated metal ion levels did not correlate with impaired renal function in this cohort.
Introduction:
The aim of our study was to investigate a potential influence of elevated serumcobalt and serumchromiumlevels on renal function at minimum 10 years after implantation of a metal-on-metal hip.
Materials And Methods:
Between November 1992 and June 1994 98 patients (44 m, 54 f) with an average age of 56 (22-79) years received a metal-on-metal bearing Metasul. At the time of the 10-year follow-up, 15 patients had died and 8 were lost to follow-up. The remaining 75 patients had laboratory analysis including serumcreatinine and full blood cell count as well as chromium and cobalt serum levels.
Results:
Ten years postoperatively the median serumcreatinine level was 0.86 (0.55-1.51) mg/dl, the serumcreatinine clearance Ccr was in the normal range. The hemogram did not differ from that measured at the time of surgery. The median serumcobalt concentration was 0.75 (0.3-50.10) microg/l and the serumchromium concentration was 0.95 (0.3-58.6) mug/l, 10 years postoperatively.
Conclusion:
Our long-term data do not show any influence of serum cobalt or chromium concentrations on renal function following total hip arthroplasty.
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