Whole blood chromium concentration is very rarely elevated independently of whole blood cobalt

Abstract Due to the risk of adverse reactions to metal debris resulting from increased wear of the arthroplasty more than one million metal-on-metal (MoM) hip replacements worldwide are in active follow-up. Follow-up usually includes measurement of both whole blood cobalt (Co) and chromium (Cr) conc...

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Autores principales:	Olli Lainiala, Mari Karsikas, Aleksi Reito, Antti Eskelinen
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/54af0020c5ac400681e7e3d1cd91b36d
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spelling	oai:doaj.org-article:54af0020c5ac400681e7e3d1cd91b36d2021-12-02T17:38:26ZWhole blood chromium concentration is very rarely elevated independently of whole blood cobalt10.1038/s41598-021-91512-92045-2322https://doaj.org/article/54af0020c5ac400681e7e3d1cd91b36d2021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-91512-9https://doaj.org/toc/2045-2322Abstract Due to the risk of adverse reactions to metal debris resulting from increased wear of the arthroplasty more than one million metal-on-metal (MoM) hip replacements worldwide are in active follow-up. Follow-up usually includes measurement of both whole blood cobalt (Co) and chromium (Cr) concentrations. Our experience is that Cr is seldom independently elevated. We wanted to ascertain whether blood Cr measurements could be omitted from follow-up protocols without lowering the quality of follow-up. We identified 8438 whole blood Co and Cr measurements performed without or prior to revision surgery. When the cut-off levels 5 µg/L and 7 µg/L were used, Cr was independently elevated in only 0.5% (95% confidence interval, CI, 0.3 to 0.6) and 0.2% (CI 0.1 to 0.3) of the measurements. The models with continuous variables showed that the higher the blood metal concentrations are the lower the percentage of measurements with Cr higher than Co. Our results suggest that whole blood Cr is very rarely independently elevated and therefore the authorities should consider omitting Cr measurements from their screening guidelines of MoM hip replacements. We believe this change in practice would simplify follow-up and lead to cost savings without decreasing the quality of follow-up.Olli LainialaMari KarsikasAleksi ReitoAntti EskelinenNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Olli Lainiala Mari Karsikas Aleksi Reito Antti Eskelinen Whole blood chromium concentration is very rarely elevated independently of whole blood cobalt
description	Abstract Due to the risk of adverse reactions to metal debris resulting from increased wear of the arthroplasty more than one million metal-on-metal (MoM) hip replacements worldwide are in active follow-up. Follow-up usually includes measurement of both whole blood cobalt (Co) and chromium (Cr) concentrations. Our experience is that Cr is seldom independently elevated. We wanted to ascertain whether blood Cr measurements could be omitted from follow-up protocols without lowering the quality of follow-up. We identified 8438 whole blood Co and Cr measurements performed without or prior to revision surgery. When the cut-off levels 5 µg/L and 7 µg/L were used, Cr was independently elevated in only 0.5% (95% confidence interval, CI, 0.3 to 0.6) and 0.2% (CI 0.1 to 0.3) of the measurements. The models with continuous variables showed that the higher the blood metal concentrations are the lower the percentage of measurements with Cr higher than Co. Our results suggest that whole blood Cr is very rarely independently elevated and therefore the authorities should consider omitting Cr measurements from their screening guidelines of MoM hip replacements. We believe this change in practice would simplify follow-up and lead to cost savings without decreasing the quality of follow-up.
format	article
author	Olli Lainiala Mari Karsikas Aleksi Reito Antti Eskelinen
author_facet	Olli Lainiala Mari Karsikas Aleksi Reito Antti Eskelinen
author_sort	Olli Lainiala
title	Whole blood chromium concentration is very rarely elevated independently of whole blood cobalt
title_short	Whole blood chromium concentration is very rarely elevated independently of whole blood cobalt
title_full	Whole blood chromium concentration is very rarely elevated independently of whole blood cobalt
title_fullStr	Whole blood chromium concentration is very rarely elevated independently of whole blood cobalt
title_full_unstemmed	Whole blood chromium concentration is very rarely elevated independently of whole blood cobalt
title_sort	whole blood chromium concentration is very rarely elevated independently of whole blood cobalt
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/54af0020c5ac400681e7e3d1cd91b36d
work_keys_str_mv	AT ollilainiala wholebloodchromiumconcentrationisveryrarelyelevatedindependentlyofwholebloodcobalt AT marikarsikas wholebloodchromiumconcentrationisveryrarelyelevatedindependentlyofwholebloodcobalt AT aleksireito wholebloodchromiumconcentrationisveryrarelyelevatedindependentlyofwholebloodcobalt AT anttieskelinen wholebloodchromiumconcentrationisveryrarelyelevatedindependentlyofwholebloodcobalt
_version_	1718379820650332160

Whole blood chromium concentration is very rarely elevated independently of whole blood cobalt

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