Orthopedics Research Today is a free monthly online journal that collates and summarizes the latest research about Orthopedics, including details on chronic injuries, muscoskeletal disorders, surgery, reconstruction. | ||||||||
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Time-dependent release of cobalt and chromium ions into the serum following implantation of the metal-on-metal Mavericktrade mark type artificial lumbar disc (Medtronic Sofamor Danek).Zeh A, Becker C, Planert M, Lattke P, Wohlrab D Department of Orthopedics and Traumatology, Martin-Luther-University of Halle-Wittenberg, Faculty of Medicine, Magdeburger Str. 22, 06097, Halle/Saale, Germany, alexander.zeh@medizin.uni-halle.de. INTRODUCTION: In total hip endoprosthetics and consequently for TDA, metal-on-metal combinations are used with the aim of reducing wear debris. In metal-on-metal TDA the release of metal ions has until now been secondary to the main discussion. MATERIALS AND METHODS: In order to investigate the ion release following the implantation of the metal-on-metal Mavericktrade mark type artificial lumbar disc we measured the serum cobalt and chromium concentration following implantation of 15 Mavericktrade mark TDAs (monosegmental L5/S1, n = 5; bisegmental L4/5 and L5/S1, n = 5; average age 36.5 years). Five healthy subjects (no metal implants) acted as a control group. The two measurements of the metals were carried out using the absorption spectrometry after an average of 14.8 and 36.7 months. RESULTS: In summary, the concentrations of cobalt and chromium ions in the serum at both follow-ups amounted on average to 3.3 mug/l (SD 2.6) for cobalt and 2.2 mug/l (SD 1.5) for chromium. These figures are similar to the figures shown in the literature following the implantation of metal-on-metal THA. After a comparison to the control group, both the chromium and cobalt levels in the serum showed visible increases regarding the first and the second follow-up. DISCUSSION: As there is still a significant release of cobalt and chromium into the serum after an average follow-up of 36.7 months a persistent release of these ions must be taken into consideration. Despite the evaluation of the systemic and local effects of the release of Cr/Co from orthopaedic implants has not yet been concluded, one should take into consideration an explanation given to patients scheduled for the implantation of a metal-on-metal TDA about these results and the benefits/risks of alternative combinations of gliding contact surfaces. Published 1 July 2008 in Arch Orthop Trauma Surg.
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