December 11, 2017
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High blood cobalt, chromium levels had no cardiotoxic effect on patients with MoM implants

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Recently published results showed high blood cobalt and chromium levels did not have any significant cardiotoxic effect among patients with a metal-on-metal hip implant.

Reshid Berber, MRCS, and colleagues categorized 90 patients who underwent total hip replacement by whether they received a ceramic-on-ceramic (CoC) bearing (group A), a metal-on-metal (MoM) bearing and had low blood metal-ion levels (group B) or a MoM bearing and had high blood metal-ion levels (group C). Using cardiac MRI with T2*, T1 and extracellular volume mapping, researchers collected detailed cardiovascular phenotyping in all patients. Patients also underwent echocardiography and cardiac blood biomarker sampling.

Results showed a significant difference in blood cobalt levels among groups A, B and C, and between group A and groups B and C combined. Researchers noted no significant between-group differences in the left atrial or ventricle size, ejection fraction, T1 or T2* values, extracellular volume, B-type natriuretic peptide level or troponin level. According to results, all values were within normal ranges. Researchers also found no relationship between cobalt levels and ejection fraction.

“We feel these results will have an impact to reassure the patients who continue to have [a] MoM hip implant in situ, to assist surgeons who are faced with patients with elevated metal levels to help guide their decision on whether to review or not and, lastly, for orthopedic societies and regulatory agencies worldwide that provide guidance on managing patients with MoM hip implants,” Berber told Healio.com/Orthopedics. – by Casey Tingle

Disclosures: Berber reports he receives grants from Gwen Fish Orthopaedic Charitable Trust. Please see the full study for a list of all other authors’ relevant financial disclosures.