The Correlation of Serum Metal Ions with Functional Outcome Scores at Three-to-Six Years following Large Head Metal-on-Metal Hip Arthroplasty

Based on success of hip resurfacing, large head Metal on Metal (MoM) hip arthroplasty has gained significant popularity in recent years. There are growing concerns about metal ions related soft tissue abnormalities. The aim of this study was to define a correlation of metal ions with various functional outcome scores following large head MoM hip arthroplasty. Consecutive cohort of 70 patients (76 hips) with large head MoM hip arthroplasty using SL-Plus femoral stem and Cormet acetabular component were prospectively followed up. An independent observer assessed the patients which included serology for metal ion levels and collection of Oxford Hip, Harris hip, WOMAC, SF-36 & modified UCLA scores. Median serum cobalt and chromium levels were 3.10 μg/L (0.35-62.92) and 4.21 μg/L (0.73-69.27) with total of median 7.30 μg/L (2.38-132.19). The median Oxford, Harris, WOMAC, SF-36 and modified UCLA scores were 36 (6-48), 87 (21-100), 36 (24-110), 104 (10-125), and 3 (1-9), respectively. Seventeen patients had elevated serum cobalt and chromium levels ≥7 μg/L. There was no significant correlation between serum metal ion levels with any of these outcome scores. We recommend extreme caution during follow up of these patients with large head MoM arthroplasty.