Copyright] 998 by The Journal of Bone and Joint Surgery, Incorporated Metal Release in Patients Who Have Had a Primary Total Hip Arthroplasty

ABSTRACT. There is an increasing recognition that, in the long term, total joint replacement may be associ-ated with adverse local and remote tissue responses that are mediated by the degradation products of prosthetic materials. Particular interest has centered on the metal-degradation products of total joint replacements because of the known toxicities of the metal elements that make up the alloys used in the implants. We measured the concentrations of titanium, aluminum, cobalt, and chro-mium in the serum and the concentration of chromium in the urine of seventy-five patients during a three-year prospective, longitudinal study. Twenty patients had had a so-called hybrid total hip replacement (insertion of a modular cobalt-alloy femoral stem and head with ce-ment and a titanium acetabular cup without cement)