JBJS | Ion Production and Excretion in a Patient with a Metal-on-Metal Bearing Hip Prosthesis: A Case Report

The Journal of Bone & Joint Surgery, Volume 89, Issue 12

Case Reports | December 01, 2007

Ion Production and Excretion in a Patient with a Metal-on-Metal Bearing Hip Prosthesis: A Case Report

Rudi G. Bitsch, MD¹; Michelle Zamorano²; Travis Loidolt, BA²; Christian Heisel, MD¹; Joshua J. Jacobs, MD³; Thomas P. Schmalzried, MD²

¹ Stiftung Orthopädische Universitätsklinik, Schlierbacher Landstrasse 200A, 69118 Heidelberg, Germany
² Joint Replacement Institute at Orthopaedic Hospital, 2400 South Flower Street, Los Angeles, CA 90007. E-mail address for T.P. Schmalzried: schmalzried@earthlink.net
³ Rush University Medical Center, 1653 West Congress Parkway, Chicago, IL 60612

The Journal of Bone & Joint Surgery. 2007; 89:2758-2763 doi:10.2106/JBJS.F.00551

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Metal-on-metal bearings have been associated with the generation of metal particles and ions^1,2 and, in comparison with that seen in other bearing surfaces, a measurable increase in the concentration of cobalt and chromium ions in blood and urine^3-7. The risks of higher ion levels include delayed-type hypersensitivity, organ toxicity, and carcinogenesis^8-10. Studies of cobalt and chromium ion levels have demonstrated variability from patient to patient^4,7. Levels tend to be highest in the short-term and, with a well-functioning prosthesis, decrease with time⁴.

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excretory function ; cobalt ; metals ; chromium ; hip joint prosthesis ; urine ; urine volume

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These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.

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