Echocardiographic Changes in the Context of Metal-on-Metal Versus Nonmetal-on-Metal Total Hip Arthroplasty
Published by Elsevier Inc..
BACKGROUND: The purpose of this study is to determine if there is a difference in echocardiographic results between patients with metal-on-metal (MoM) vs non-MoM total hip arthroplasty (THA) and to determine if a correlation exists between serum metal levels and echocardiographic outcomes.
METHODS: Seventy-five patients with the same modular THA enrolled in this prospective cohort study, and 49 had MoM bearings. All patients had serum cobalt, chromium, and titanium levels drawn at 2 study visits with a transthoracic echocardiogram at the second visit. Serum metal concentrations and echocardiographic parameters were compared with 2-way t-tests. Multiple linear regression analyses identified any significant predictors of echocardiographic outcomes.
RESULTS: Mean serum cobalt and chromium levels were significantly greater in the MoM group at both time-points (P < .001 and P < .05, respectively). Titanium levels were similar between groups (P > .05). MoM patients had significantly lower global longitudinal strain compared with the non-MoM group (18.4% vs 20.2%; P = .026). Serum cobalt concentration was found to be an independent predictor of tricuspid annular plane systolic excursion (P = .02).
CONCLUSION: MoM THA bearings are associated with increased serum cobalt and chromium levels. Patients with MoM THAs had decreased global longitudinal strain, a measure of left ventricular function, but both groups remained within normal range. The clinical impact of the positive association between serum cobalt concentration and tricuspid annular plane systolic excursion, a marker of right ventricular function, deserves further study. These findings can reassure physicians and patients that metal-induced cardiomyopathy is not typical in the setting of MoM THA.
LEVEL OF EVIDENCE: Level II, Prospective Cohort Study.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:35 |
|---|---|
| Enthalten in: |
The Journal of arthroplasty - 35(2020), 11 vom: 01. Nov., Seite 3230-3236.e3 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Darrith, Brian [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
0R0008Q3JB |
|---|
| Anmerkungen: |
Date Completed 02.04.2021 Date Revised 02.04.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.arth.2020.06.020 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM312416954 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM312416954 | ||
| 003 | DE-627 | ||
| 005 | 20231225144355.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.arth.2020.06.020 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1041.xml |
| 035 | |a (DE-627)NLM312416954 | ||
| 035 | |a (NLM)32665157 | ||
| 035 | |a (PII)S0883-5403(20)30660-4 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Darrith, Brian |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Echocardiographic Changes in the Context of Metal-on-Metal Versus Nonmetal-on-Metal Total Hip Arthroplasty |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 02.04.2021 | ||
| 500 | |a Date Revised 02.04.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published by Elsevier Inc. | ||
| 520 | |a BACKGROUND: The purpose of this study is to determine if there is a difference in echocardiographic results between patients with metal-on-metal (MoM) vs non-MoM total hip arthroplasty (THA) and to determine if a correlation exists between serum metal levels and echocardiographic outcomes | ||
| 520 | |a METHODS: Seventy-five patients with the same modular THA enrolled in this prospective cohort study, and 49 had MoM bearings. All patients had serum cobalt, chromium, and titanium levels drawn at 2 study visits with a transthoracic echocardiogram at the second visit. Serum metal concentrations and echocardiographic parameters were compared with 2-way t-tests. Multiple linear regression analyses identified any significant predictors of echocardiographic outcomes | ||
| 520 | |a RESULTS: Mean serum cobalt and chromium levels were significantly greater in the MoM group at both time-points (P < .001 and P < .05, respectively). Titanium levels were similar between groups (P > .05). MoM patients had significantly lower global longitudinal strain compared with the non-MoM group (18.4% vs 20.2%; P = .026). Serum cobalt concentration was found to be an independent predictor of tricuspid annular plane systolic excursion (P = .02) | ||
| 520 | |a CONCLUSION: MoM THA bearings are associated with increased serum cobalt and chromium levels. Patients with MoM THAs had decreased global longitudinal strain, a measure of left ventricular function, but both groups remained within normal range. The clinical impact of the positive association between serum cobalt concentration and tricuspid annular plane systolic excursion, a marker of right ventricular function, deserves further study. These findings can reassure physicians and patients that metal-induced cardiomyopathy is not typical in the setting of MoM THA | ||
| 520 | |a LEVEL OF EVIDENCE: Level II, Prospective Cohort Study | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Profemur Z | |
| 650 | 4 | |a chromium | |
| 650 | 4 | |a cobalt | |
| 650 | 4 | |a cobalt cardiomyopathy | |
| 650 | 4 | |a metal-on-metal | |
| 650 | 4 | |a total hip arthroplasty | |
| 650 | 7 | |a Chromium |2 NLM | |
| 650 | 7 | |a 0R0008Q3JB |2 NLM | |
| 650 | 7 | |a Cobalt |2 NLM | |
| 650 | 7 | |a 3G0H8C9362 |2 NLM | |
| 700 | 1 | |a Rahman, Tahsin M |e verfasserin |4 aut | |
| 700 | 1 | |a Ananthasubramaniam, Karthikeyan |e verfasserin |4 aut | |
| 700 | 1 | |a Culvern, Chris |e verfasserin |4 aut | |
| 700 | 1 | |a Jacobs, Joshua J |e verfasserin |4 aut | |
| 700 | 1 | |a Silverton, Craig D |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Journal of arthroplasty |d 1995 |g 35(2020), 11 vom: 01. Nov., Seite 3230-3236.e3 |w (DE-627)NLM012629375 |x 1532-8406 |7 nnns |
| 773 | 1 | 8 | |g volume:35 |g year:2020 |g number:11 |g day:01 |g month:11 |g pages:3230-3236.e3 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.arth.2020.06.020 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 35 |j 2020 |e 11 |b 01 |c 11 |h 3230-3236.e3 | ||