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Erythrocyte levels 'should not be used for gauging arthroplasty exposure risk'

Erythrocyte levels are unsuitable for gauging exposure risk in metal-on-metal arthroplasty, according to a new study.

Research findings due to be presented at the 11th EFORT Congress in Madrid by a team from the UK's Birmingham University show that the variability with plasma and erythrocytes when compared to whole blood metal ion levels means they are not ideal as markers for systemic chromium exposure, reports Ortho Supersite.

"Analysis of whole blood specimens is the ideal way to assess systemic exposure," lead author Joseph Daniel, FRCS, told Orthopaedics Today Europe.

"In the past, limitations in instrument sensitivity limited our ability to assess whole blood specimens. Now, with the availability of high-resolution, inductively-coupled mass-spectrometry, this is no longer an issue."

Over the course of the research, 461 concurrent specimens of whole blood, plasma and erythrocytes patients with large and small-diameter metal-metal hip arthroplasties were analysed.

It was concluded that variability in plasma chromium was poorer at lower levels, while variability in erythrocytes proved worse when levels were higher.

Due to the large sample size of participants, the researchers stated that it provides sufficient support for not using erythrocyte levels as markers of systemic chromium exposure.

Last week, it was reported by Ortho Supersite that a new study has shown that ceramic-on-metal total hip arthroplasty (THA) articulations result in lower blood chromium levels in comparison with metal-on-metal articulations.

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