Related Experiment Video

Updated: May 9, 2026

Quantification of Metal Leaching in Immobilized Metal Affinity Chromatography
05:35

Quantification of Metal Leaching in Immobilized Metal Affinity Chromatography

Published on: January 17, 2020

Blood metal ion testing is an effectivescreening tool to identify poorly performing metal-on-metal bearingsurfaces

R P Sidaginamale1, T J Joyce, J K Lord

  • 1Newcastle University, StephensonBuilding, Claremont Road, Newcastleupon Tyne NE1 7RU, UK.

Bone & Joint Research
|July 10, 2013
PubMed

Insights

Blood and serum metal ion levels, specifically cobalt (Co) and chromium (Cr), reliably indicate abnormal wear in metal-on-metal hip implants. Blood cobalt is a key indicator for detecting implant wear.

Area of Science:

  • Biomaterials Science
  • Orthopedic Surgery
  • Clinical Chemistry

Background:

  • Metal-on-metal (MoM) hip resurfacings can release chromium (Cr) and cobalt (Co) ions.
  • Understanding background and implant-related metal ion levels is crucial for patient monitoring.
  • The distribution of these ions in blood and serum requires further investigation.

Purpose of the Study:

  • To establish baseline blood Cr and Co concentrations in a large cohort.
  • To correlate blood/serum Cr and Co levels with retrieved MoM hip implants.
  • To analyze the distribution and partitioning of Co and Cr ions in blood and serum.

Main Methods:

  • Analysis of 3042 blood samples for Co and Cr.
  • Volumetric wear assessment of 91 retrieved MoM hip devices.
  • Linear regression and ROC curve analysis to evaluate ion reliability.
  • Bland-Altman analysis and in vitro spiking studies to examine serum vs. whole blood partitioning.

Main Results:

  • Blood Co and Cr concentrations effectively indicate abnormal implant wear.
  • Blood cobalt levels of 4.5 µg/l demonstrated 94% sensitivity and 95% specificity for detecting abnormal wear.
  • Metal ions preferentially accumulate in the serum compartment, both in vivo and in vitro.

Conclusions:

  • Blood and serum metal ion concentrations serve as reliable biomarkers for abnormal wear in MoM hip arthroplasties.
  • Significant differences exist in ion distribution between blood fractions and elements.
  • Future clinical guidelines should account for these element- and fraction-specific differences.
Abstract

Keywords:
ARMDArthroplastyChromiumCobaltHip resurfacingMetal ionsMetal-on-metalVolumetric wear

More Related Videos

Standards for Quantitative Metalloproteomic Analysis Using Size Exclusion ICP-MS09:51

Standards for Quantitative Metalloproteomic Analysis Using Size Exclusion ICP-MS

Published on: April 13, 2016

Handheld Metal Detector Screening for Metallic Foreign Body Ingestion in Children04:55

Handheld Metal Detector Screening for Metallic Foreign Body Ingestion in Children

Published on: September 11, 2018

Related Concept Videos

Effects of EDTA on End-Point Detection Methods01:18

Effects of EDTA on End-Point Detection Methods

Different methods, such as visual observance of metal-ion indicators, spectroscopic techniques, and potentiometric methods, can determine the endpoint of an EDTA titration.
In the visual method, metal-ion indicators (metallochromic dyes), which have distinct colors in their free and complex forms, are added to the mixture to signal the titration's end point. They form stable complexes with metal ions, but these complexes are weaker than the corresponding metal–EDTA complexes. As a result, EDTA...
Qualitative Analysis03:46

Qualitative Analysis

For solutions containing mixtures of different cations, the identity of each cation can be determined by qualitative analysis. This technique involves a series of selective precipitations with different chemical reagents, each reaction producing a characteristic precipitate for a specific group of cations. Metal ions within a group are further separated by varying the pH, heating the mixture to redissolve a precipitate, or adding other reagents to form complex ions.
For instance, group IV...
EDTA: Direct, Back-, and Displacement Titration01:30

EDTA: Direct, Back-, and Displacement Titration

The EDTA titration types for metal ion analysis include direct titration, back-titration, and replacement titration.
Direct titration involves buffering the metal ion solution to the desired pH and directly titrating with standard EDTA until the endpoint. The optimum pH ensures a large conditional formation constant of metal−EDTA and visibility of the free indicator color in the solution. In addition, auxiliary complexing reagents are used to prevent the precipitation of metal hydroxides and...
Complexometric Titration: Overview00:39

Complexometric Titration: Overview

Complexometric titration involves the formation of a complex by reacting a metal ion with one or more ligands. A visual indicator often detects the end point of a complexometric titration. It is added to the metal solution before the titration, forming a stable metal–indicator complex and imparting color to the solution. As the titration approaches the equivalence point, the excess of the added ligand displaces the indicator from the metal–indicator complex, releasing the free indicator. The...