Imperial College London
Alternate

MrBarrySampson

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Honorary Senior Research Fellow
 
 
 
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Contact

 

+44 (0)20 3313 3644b.sampson Website

 
 
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Location

 

GMO 02 Medical Oncology BlockMedical OncologyCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Hart:2014:10.2106/JBJS.M.00957,
author = {Hart, AJ and Sabah, SA and Sampson, B and Skinner, JA and Powell, JJ and Palla, L and Pajamäki, KJJ and Puolakka, T and Reito, A and Eskelinen, A},
doi = {10.2106/JBJS.M.00957},
journal = {J Bone Joint Surg Am},
pages = {1091--1099},
title = {Surveillance of Patients with Metal-on-Metal Hip Resurfacing and Total Hip Prostheses: A Prospective Cohort Study to Investigate the Relationship Between Blood Metal Ion Levels and Implant Failure.},
url = {http://dx.doi.org/10.2106/JBJS.M.00957},
volume = {96},
year = {2014}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: We designed a prospective, single-center study to assess whether blood metal ion levels could predict implant failure in patients managed with unilateral metal-on-metal hip resurfacing or total hip arthroplasty. METHODS: Five hundred and ninety-seven patients who had received unilateral Articular Surface Replacement prostheses at least twelve months earlier were recruited. Blood metal ion levels were compared between the group of patients with failed implants and the group with non-failed implants. Implant failure was defined as prostheses associated with revision, an intention to revise, or poor patient-reported hip function (Oxford Hip Score, <31 of 48). Specificity, sensitivity, area under the curve, positive and negative predictive values, and odds ratios were calculated. Logistic regression analysis was used to identify other risk factors for implant failure. RESULTS: Patients with failed arthroplasty had significantly higher blood cobalt and chromium ion levels than did patients with non-failed arthroplasty (p < 0.01). Blood cobalt ion levels were disproportionately raised in patients with failed total hip arthroplasty (8.2 μg/L) compared with patients with failed hip resurfacing (2.5 μg/L) (p = 0.018). Blood chromium ion levels were not significantly different in patients with failed total hip arthroplasty and failed hip resurfacing (p = 0.058). The maximum value of either metal ion had good discriminant ability to predict implant failure (area under the curve, 0.76). A 7-μg/L cutoff had a positive predictive value of 0.75 (95% confidence interval, 0.66 to 0.82) and a negative predictive value of 0.82 (95% confidence interval, 0.78 to 0.86). In patients managed with total hip arthroplasty, for each increase of 1 μg/L there was a 23% (p < 0.001) increase in the odds of them being in the failed group. For patients managed with hip resurfacing, the increase in odds was 5% (p < 0.001). CONCLUSIONS: Raised levels of blood metal
AU  - Hart,AJ
AU  - Sabah,SA
AU  - Sampson,B
AU  - Skinner,JA
AU  - Powell,JJ
AU  - Palla,L
AU  - Pajamäki,KJJ
AU  - Puolakka,T
AU  - Reito,A
AU  - Eskelinen,A
DO  - 10.2106/JBJS.M.00957
EP  - 1099
PY  - 2014///
SP  - 1091
TI  - Surveillance of Patients with Metal-on-Metal Hip Resurfacing and Total Hip Prostheses: A Prospective Cohort Study to Investigate the Relationship Between Blood Metal Ion Levels and Implant Failure.
T2  - J Bone Joint Surg Am
UR  - http://dx.doi.org/10.2106/JBJS.M.00957
UR  - https://www.ncbi.nlm.nih.gov/pubmed/24990974
VL  - 96
ER  -
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