Metal Determination in Organic Fluids of Patients with Stainless Steel Hip Arthroplasty

In 20 stainless steel Charnley hip arthroplasties (with a follow-up of 10-13 years) nickel, chromium and manganese levels were measured in blood, plasma and urine by atomic absorption spectrophotometry. Skin patch tests for these metals, and clinical and roentgenographic results of arthroplasty were also assessed. Metal levels in organic fluids were plotted against a control population homogeneous for age, residence and anamnestic conditions with the first, but which had never undergone a prosthesis or other metallic implant surgical procedure. Nickel levels in blood, plasma and urine, manganese levels in blood and urine and chromium levels in plasma were significantly higher in the hip prostheses population. Metal ion release from stainless steel prostheses is discussed with regard to implant failure, metal sensitivity and carcinogenesis.