ICJR Interviews: Screening for Metal Ion Levels in the Blood

    Recommendations for evaluating patients with metal-on-metal (MoM) implants often include measurement of metal ion levels in the blood – specifically, cobalt and chromium levels – for evidence of an adverse reaction to metal debris (ARMD).

    The problem is, there’s no consensus on what level constitutes evidence of an ARMD, calling into question the diagnostic value of these tests.

    Paul E. Beaulé, MD, FRCSC, from the University of Ottawa in Canada, and colleagues undertook a systematic review and meta-analysis of studies evaluating metal ion testing for ARMDs. Six articles met their inclusion criteria, with more than 300 of the 800 patients having a diagnosed ARMD.

    Using sophisticated statistical analyses, they determined that even at various cut-off points for the blood levels, metal ion testing is not a useful screening tool for determining which patients are at high risk for ARMDs. In fact, relying on metal ion levels in the blood could lead to overtreatment based on false positives.

    Click the image above the hear Dr. Beaulé discuss the findings of the study, “Metal Ion Levels are not a Useful Test for Failed Metal-On-Metal Hip Implants: A Systematic Review and Meta-Analysis” (Paper 006), which was presented at the 2016 Annual Meeting of the American Academy of Orthopaedic Surgeons in Orlando.

    Producer: Henrik B. Pedersen, MD; Director: Michael Bugera; Post Production: Charles J. Maynard