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

Ilona Swiatkowska1, Nicholas G Martin2, Johann Henckel3

  • 1Institute of Orthopaedics and Musculoskeletal Science, University College London, HA7 4LP Stanmore, UK.

Journal of Trace Elements in Medicine and Biology : Organ of the Society for Minerals and Trace Elements (GMS)
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Researchers established the first laboratory reference levels for blood and plasma titanium in patients with titanium hip implants. This provides a crucial biomarker for assessing orthopaedic implant performance.

Keywords:
Blood titaniumHR ICP-MSReference rangeTMZFTotal hip arthroplastyToxicity

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Area of Science:

  • Biomaterials science
  • Orthopaedic surgery
  • Analytical chemistry

Background:

  • Hip implants commonly use cobalt-chromium and titanium alloys.
  • Metal debris from implants can serve as biomarkers for implant function.
  • No established reference levels exist for blood titanium, unlike cobalt and chromium.

Purpose of the Study:

  • To establish laboratory reference levels for blood and plasma titanium.
  • To investigate titanium as a biomarker for titanium hip implant function.

Main Methods:

  • Recruited 95 patients with a single type of hip implant.
  • Assessed clinical and radiological outcomes.
  • Measured blood and plasma titanium using high-resolution inductively-coupled plasma mass spectrometry.

Main Results:

  • Established upper normal reference limits for blood titanium at 2.20 μg/L.
  • Established upper normal reference limits for plasma titanium at 2.56 μg/L.
  • No significant sex-based differences in titanium levels were observed.

Conclusions:

  • First proposed laboratory reference levels for blood and plasma titanium in patients with functioning titanium hip implants.
  • These reference levels are essential for future studies on implant performance biomarkers.
  • Findings are relevant given current discussions surrounding titanium alloy use in hip arthroplasty.