دورية أكاديمية
Whole Blood Metal Levels in the Setting of an Oncologic Endoprosthesis: Is There Cause for Concern?
| العنوان: | Whole Blood Metal Levels in the Setting of an Oncologic Endoprosthesis: Is There Cause for Concern? |
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| المؤلفون: | Houdek MT; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA., Couch CG; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA., Wyles CC; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA., Taunton MJ; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA., Rose PS; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA., Kremers HM; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA., Lewallen DG; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA., Berry DJ; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA. |
| المصدر: | Clinical orthopaedics and related research [Clin Orthop Relat Res] 2024 Feb 01; Vol. 482 (2), pp. 352-358. Date of Electronic Publication: 2023 Aug 21. |
| نوع المنشور: | Review; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wolters Kluwer Country of Publication: United States NLM ID: 0075674 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1132 (Electronic) Linking ISSN: 0009921X NLM ISO Abbreviation: Clin Orthop Relat Res Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2018- : [New York, NY] : Wolters Kluwer Original Publication: Philadelphia : Lippincott, |
| مواضيع طبية MeSH: | Hip Prosthesis* , Arthroplasty, Replacement, Hip*/adverse effects, Humans ; Male ; Female ; Retrospective Studies ; Prospective Studies ; Cross-Sectional Studies ; Prosthesis Design ; Chromium ; Cobalt ; Prosthesis Failure |
| مستخلص: | Background: Massive modular endoprostheses have become a primary means of reconstruction after oncologic resection of a lower extremity tumor. These implants are commonly made with cobalt-chromium alloys that can undergo wear and corrosion, releasing cobalt and chromium ions into the surrounding tissue and blood. However, there are few studies about the blood metal levels in these patients. Question/purpose: What is the whole blood cobalt and chromium ion level in patients with massive modular endoprostheses? Methods: We performed a cross-sectional study of our total joints registry to identify patients with a history of an endoprosthetic reconstruction performed at our institution. Patients who were alive at the time of our review in addition to those undergoing an endoprosthetic reconstruction after an oncologic resection were included. Whole blood samples were obtained from 27 (14 male and 13 female) patients with a history of a lower extremity oncologic endoprosthesis. The median time from surgery to blood collection was 8 years (range 6 months to 32 years). Blood samples were collected and stored in metal-free ethylenediaminetetraacetic acid tubes. Samples were analyzed on an inductively coupled plasma mass spectrometer in an International Organization for Standardization seven-class clean room using polytetrafluoroethylene-coated instruments to reduce the risk of metal contamination. The analytical measuring range was 1 to 200 ng/mL for chromium and cobalt. Cobalt and chromium levels were considered elevated when the blood level was ≥ 1 ppb. Results: Cobalt levels were elevated in 59% (16 of 27) of patients, and chromium levels were elevated in 26% (seven of 27). In patients with elevated metal ion values, 15 of 17 patients had a reconstruction using a Stryker/Howmedica Global Modular Replacement System implant. Conclusion: Blood metal levels were elevated in patients who received reconstructions using modular oncology endoprostheses Future work is needed to establish appropriate follow-up routines and determine whether and when systemic complications occur because of elevated metal levels and how to potentially address these elevated levels when complications occur. Prospective and retrospective collaboration between multiple centers and specialty societies will be necessary to address these unknown questions in this potentially vulnerable patient group. Level of Evidence: Level IV, therapeutic study. Competing Interests: Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. (Copyright © 2023 by the Association of Bone and Joint Surgeons.) |
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| معلومات مُعتمدة: | R01 AG060920 United States AG NIA NIH HHS; R01 HL147155 United States HL NHLBI NIH HHS |
| المشرفين على المادة: | 0R0008Q3JB (Chromium) 3G0H8C9362 (Cobalt) |
| تواريخ الأحداث: | Date Created: 20230821 Date Completed: 20240201 Latest Revision: 20240210 |
| رمز التحديث: | 20240210 |
| مُعرف محوري في PubMed: | PMC10776170 |
| DOI: | 10.1097/CORR.0000000000002805 |
| PMID: | 37603308 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1528-1132 |
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| DOI: | 10.1097/CORR.0000000000002805 |