Biological Monitoring of Metal Ions Released from Hip Prostheses

Annamaria Nicolli, Andrea Trevisan, Isabella Bortoletti, Assunta Pozzuoli, Pietro Ruggieri, Andrea Martinelli, Alberto Gambalunga and Mariella Carrieri
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Annamaria Nicolli: Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
Andrea Trevisan: Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
Isabella Bortoletti: Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
Assunta Pozzuoli: Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128 Padova, Italy
Pietro Ruggieri: Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128 Padova, Italy
Andrea Martinelli: Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
Alberto Gambalunga: Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
Mariella Carrieri: Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy

IJERPH, 2020, vol. 17, issue 9, 1-7

Abstract: The aim of this study was to evaluate the levels of As, Be, Bi, Cd, Co, Cr, Cu, Hg, Mn, Ni, Pb, Se, Tl, V, and Zn, by inductively coupled plasma-mass spectrometry (ICP-MS) in the urine of two groups of patients with two different types of metal-on-metal (MoM) total hip prostheses (ASR DePuy ® , group A, 25 patients; total Met-Met System Lima ® , group B, 28 patients). The determination of metals reflected a steady-state release (group A: 9 years after surgery and group B: 6 years after surgery). The results obtained confirmed the increase of Co and Cr urinary levels in both group when compared with the reference values for the general population adopted by the Italian Society of Reference Values (SIVR). In particular, Co and Cr levels exceeded the threshold values in urine, respectively, of 30 μg and 21 µg, adjusted to creatinine based on the threshold in whole blood of 7 μg/L proposed by the Medicines and Healthcare Products Regulatory Agency (MHRA). Regarding the other investigated metals, significantly higher values were found in Group A than in Group B. These differences could be due to the type of hip prosthesis implanted, the longer period of time since the implantation, as well as many other factors such as diet, age, drug consumption, physical activity, or presence of dental fillings. The continuous monitoring over the years of metal concentrations in patients carrying a prosthesis could be useful to better identify the sources of these metals.

Keywords: hip prostheses; metal ions; metal debris; biological monitoring (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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