[Serum cobalt and serum chromium level in 2 patients with chronic renal failure after total hip prosthesis implantation with metal-metal gliding contact].

PURPOSE

The influence of chronic renal failure on serum cobalt and serum chromium in two patients with metal-on-metal bearing (Metasul) and cementless total hip arthroplasty (Alloclassic) is investigated.

METHODS

Serum cobalt and serum chronium levels were determined in the postoperative course using atomic absorption spectrometry.

RESULTS

Maximum values are found to be more than 100-fold elevated when compared to the reported median serum cobalt concentrations in patients with the same prosthesis type and no known renal disease.

CONCLUSION

Chronic renal failure seems to be responsible for the marked elevation of serum cobalt and serum chromium.

CLINICAL RELEVANCE

Despite evidence of adverse health reactions, a possible effect of long-term cobalt and chromium loading cannot be neglected. In our opinion, metal-on-metal bearings in THA should not be inserted in patients with chronic renal failure. Follow-up investigations (serum cobalt, serum chromium, serum creatinine, BUN, echocardiography) should be performed at short intervals.