Metal Ion Concentrations in Young, Active Patients Following Total Hip Arthroplasty with the Use of Modern Bearing Couples

The purpose of this study was to compare whole blood metal ion levels in young, active patients undergoing primary total hip arthroplasty with the use of a cobalt-alloy (ten patients), ceramic (15 patients), or oxinium (11 patients) femoral head and highly crosslinked polyethylene acetabular liner. At 2 years postoperatively, mean cobalt concentrations were 3.0 times higher in the cobalt-alloy cohort versus the ceramic cohort, and 2.3 times higher versus the oxinium cohort (P = 0.3-0.5). Titanium levels were consistently elevated at all postoperative time points versus preoperatively in all cohorts. Young, active patients following THA demonstrate elevated cobalt and titanium concentrations. Use of a ceramic or oxinium femoral head decreased the degree of cobalt elevation versus a cobalt-alloy femoral head, but did not reach statistical significance.