Differences in concentration of metal debris in blood, serum, and plasma samples of patients with metal-on-metal hip resurfacing arthroplasty

Abstract

Background/aims: Cobalt and chromium are released from MOM hips and their precise nature (ions/particles) is not known. Their distribution in serum, plasma, and whole blood may help to determine their nature.

Methods: We measured cobalt and chromium concentrations in plasma, serum, and whole blood samples of patients with resurfacing MOM hips.

Results: We found that chromium concentration was highest in plasma, followed by serum and whole blood. Chromium and cobalt concentrations were higher in serum and plasma, compared to whole blood.

Conclusion: We, therefore, suggest that in future cobalt and chromium concentrations shall be reported using plasma samples.

Keywords: Chromium; Cobalt; Metal ions; Plasma; Serum.

Figures

Fig. 1

Bland and Altman plot for intersample reliability of Cobalt measurements. ‘●’ Comparison between serum and whole blood cobalt measurements. ‘○’ Comparison between plasma and whole blood cobalt measurements. ‘▴’ Comparison between serum and plasma cobalt measurements.

Fig. 2

Bland and Altman plot for intersample reliability of chromium levels. ‘●’ Comparison between serum and whole blood measurements. ‘○’ Comparison between plasma and whole blood measurements. ‘▴’ Comparison between serum and plasma measurements.

Fig. 3

Bland and Altman plot for repeatability of cobalt levels in different matrices. ● represents measurements of serum. ○ represents measurements of plasma. ▴ represents measurements of whole blood.