Metal ion levels after metal-on-metal proximal femoral replacements: a 30-year follow-up

E Dunstan, A P Sanghrajka, S Tilley, P Unwin, G Blunn, S R Cannon, T W R Briggs

Research output: Contribution to journalArticlepeer-review


Metal-on-metal hip bearings are being implanted into younger patients. The consequence of elevated levels of potentially carcinogenic metal ions is therefore a cause for concern. We have determined the levels of cobalt (Co), chromium (Cr), titanium (Ti) and vanadium (Va) in the urine and whole blood of patients who had had metal-on-metal and metal-on-polyethylene articulations in situ for more than 30 years. We compared these with each other and with the levels for a control group of subjects. We found significantly elevated levels of whole blood Ti, Va and urinary Cr in all arthroplasty groups. The whole blood and urine levels of Co were grossly elevated, by a factor of 50 and 300 times respectively in patients with loose metal-on-metal articulations when compared with the control group. Stable metal-on-metal articulations showed much lower levels. Elevated levels of whole blood or urinary Co may be useful in identifying metal-on-metal articulations which are loose.

Original languageEnglish
Pages (from-to)628-31
Number of pages4
JournalJournal of Bone and Joint Surgery - British Volume
Issue number5
Publication statusPublished - May 2005


  • Adolescent
  • Adult
  • Aged
  • Arthroplasty, Replacement, Hip
  • Carcinogens
  • Chromium
  • Cobalt
  • Equipment Design
  • Female
  • Femur
  • Hip Prosthesis
  • Humans
  • Male
  • Metals
  • Middle Aged
  • Polyethylene
  • Titanium
  • Vanadium


Dive into the research topics of 'Metal ion levels after metal-on-metal proximal femoral replacements: a 30-year follow-up'. Together they form a unique fingerprint.

Cite this