Correlation Between Co Levels in Hair and Blood of Patients Who Underwent Metal-on-metal Hip Arthroplasty
Background: The purpose of this paper is to study the dependence of Co levels in hair on Co levels in blood after metal-on-metal (MoM) hip replacement and prove the suitability of hair analysis coupled to blood analysis in the decision process regarding implant revision evaluation. Methods: Hair sam...
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Format: | Article |
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Elsevier
2022-12-01
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Series: | Arthroplasty Today |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S235234412200214X |
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author | Marco Di Luzio Anna Ronchi Marilina Amabile Enrico Tassinari Massimo Oddone Giancarlo D’Agostino |
author_facet | Marco Di Luzio Anna Ronchi Marilina Amabile Enrico Tassinari Massimo Oddone Giancarlo D’Agostino |
author_sort | Marco Di Luzio |
collection | DOAJ |
description | Background: The purpose of this paper is to study the dependence of Co levels in hair on Co levels in blood after metal-on-metal (MoM) hip replacement and prove the suitability of hair analysis coupled to blood analysis in the decision process regarding implant revision evaluation. Methods: Hair samples of 19 MoM patients having both well-functioning and malfunctioning implants and Co mass concentration levels in blood between 0.2 μg L-1 and 221.0 μg L-1 were included. A method based on inductively coupled plasma mass spectrometry was validated and used to measure the Co level in hair. Results: The Co mass fraction in the hair of patients ranged between 0.011 mg kg-1 and 0.712 mg kg-1. A correlation analysis showed a statistically significant positive correlation (r = 0.932, P < .001) between Co in the hair and that in the blood in the full-level range and a statistically nonsignificant positive correlation (r = 0.595, P = .091) in the low-level range. Conclusions: A correlation between the Co level in the hair and that in the blood exists when the latter is clearly above the 7 μg L-1 mass concentration threshold suggested for implant revision evaluation. The correlation disappears when the Co level in blood approaches or falls down the mass concentration threshold and that in the hair approaches or falls within the normal population range of 0.004-0.14 mg kg-1. Accordingly, clinicians could consider a hair analysis coupled to a blood analysis to assess the revision of malfunctioning MoM implants that release metals in patient’s body. |
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issn | 2352-3441 |
language | English |
last_indexed | 2024-04-11T06:24:22Z |
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series | Arthroplasty Today |
spelling | doaj.art-9facb28fb68f418c9a4a077d4b9b08be2022-12-22T04:40:28ZengElsevierArthroplasty Today2352-34412022-12-01186367Correlation Between Co Levels in Hair and Blood of Patients Who Underwent Metal-on-metal Hip ArthroplastyMarco Di Luzio0Anna Ronchi1Marilina Amabile2Enrico Tassinari3Massimo Oddone4Giancarlo D’Agostino5Istituto Nazionale di Ricerca Metrologica (INRIM), Pavia, ItalyLaboratorio di Tossicologia Clinica e Sperimentale, Centro Antiveleni di Pavia - Centro Nazionale di Informazione Tossicologica, Istituti Clinici Sientifici Maugeri IRCCS Pavia, Pavia, ItalyLaboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Bologna, ItalyOrtopedia-Traumatologia e Chirurgia protesica e dei reimpianti d'anca e di ginocchio, IRCCS Istituto Ortopedico Rizzoli, Bologna, ItalyDipartimento di Chimica, Università di Pavia, Pavia, Italy; Istituto Nazionale di Ricerca Metrologica (INRIM), Pavia, ItalyIstituto Nazionale di Ricerca Metrologica (INRIM), Pavia, Italy; Corresponding author. Istituto Nazionale di Ricerca Metrologica (INRIM), via Taramelli 12, 27100 Pavia, Italy. Tel.: +39 3493208619.Background: The purpose of this paper is to study the dependence of Co levels in hair on Co levels in blood after metal-on-metal (MoM) hip replacement and prove the suitability of hair analysis coupled to blood analysis in the decision process regarding implant revision evaluation. Methods: Hair samples of 19 MoM patients having both well-functioning and malfunctioning implants and Co mass concentration levels in blood between 0.2 μg L-1 and 221.0 μg L-1 were included. A method based on inductively coupled plasma mass spectrometry was validated and used to measure the Co level in hair. Results: The Co mass fraction in the hair of patients ranged between 0.011 mg kg-1 and 0.712 mg kg-1. A correlation analysis showed a statistically significant positive correlation (r = 0.932, P < .001) between Co in the hair and that in the blood in the full-level range and a statistically nonsignificant positive correlation (r = 0.595, P = .091) in the low-level range. Conclusions: A correlation between the Co level in the hair and that in the blood exists when the latter is clearly above the 7 μg L-1 mass concentration threshold suggested for implant revision evaluation. The correlation disappears when the Co level in blood approaches or falls down the mass concentration threshold and that in the hair approaches or falls within the normal population range of 0.004-0.14 mg kg-1. Accordingly, clinicians could consider a hair analysis coupled to a blood analysis to assess the revision of malfunctioning MoM implants that release metals in patient’s body.http://www.sciencedirect.com/science/article/pii/S235234412200214XHair analysisMetal-on-metalMoM hip revisionCobalt |
spellingShingle | Marco Di Luzio Anna Ronchi Marilina Amabile Enrico Tassinari Massimo Oddone Giancarlo D’Agostino Correlation Between Co Levels in Hair and Blood of Patients Who Underwent Metal-on-metal Hip Arthroplasty Arthroplasty Today Hair analysis Metal-on-metal MoM hip revision Cobalt |
title | Correlation Between Co Levels in Hair and Blood of Patients Who Underwent Metal-on-metal Hip Arthroplasty |
title_full | Correlation Between Co Levels in Hair and Blood of Patients Who Underwent Metal-on-metal Hip Arthroplasty |
title_fullStr | Correlation Between Co Levels in Hair and Blood of Patients Who Underwent Metal-on-metal Hip Arthroplasty |
title_full_unstemmed | Correlation Between Co Levels in Hair and Blood of Patients Who Underwent Metal-on-metal Hip Arthroplasty |
title_short | Correlation Between Co Levels in Hair and Blood of Patients Who Underwent Metal-on-metal Hip Arthroplasty |
title_sort | correlation between co levels in hair and blood of patients who underwent metal on metal hip arthroplasty |
topic | Hair analysis Metal-on-metal MoM hip revision Cobalt |
url | http://www.sciencedirect.com/science/article/pii/S235234412200214X |
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