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J Toxicol Clin Toxicol. 1999;37(7):839-44.

Increased blood cobalt and chromium after total hip replacement.

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Department of Occupational Medicine, University of Vienna, Austria.



To determine metal concentrations in blood and urine of patients who received cobalt-chromium-alloy metal on metal hip implants.


Cobalt and chromium were determined in blood and urine of 76 patients and 26 controls by electrothermal atomic absorption spectroscopy.


A significant postoperative elevation of the metal concentrations was observed for total hip replacement patients in contrast to the control group. Twenty-nine patients exceeded the EKA (Expositionäquivalente für Krebserzeugende Arbeitsstoffe) threshold limits for cobalt in blood and for cobalt and chromium in urine. We obtained a significant correlation between cobalt in blood and cobalt in urine (r = 0.79; p < 0.005), chromium in blood and chromium in urine (r = 0.79; p < 0.005), cobalt in blood and chromium in blood (r = 0.69; p = 0.008), and cobalt in urine and chromium in urine (r = 0.95; p = 0.004).


Our findings suggest that in total hip replacements using metal-metal pairings, metal ions of the alloys are released. This release may lead to significantly elevated metal concentrations in biological fluids. Long-term studies are needed to determine the risk of metal-metal implants as a potential cause of cobalt and chromium toxicity.

[Indexed for MEDLINE]

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