Differences in metal ion release following cobalt-chromium and oxidized zirconium total knee arthroplasty

Ions are released from all metals after implantation in the body through processes of corrosive and mechanical wear. The aim of this study was to investigate whether serum metal ion levels are raised in patients following total knee arthroplasty. Serum levels of chromium, cobalt, aluminium, molybdenum and zirconium were measured in two groups of patients at a minimum of 3 years after knee arthroplasty. Twenty three patients had a cobalt-chromium femoral component and 14 patients had an oxidized zirconium femoral component, acting as a control group as this femoral component is free from cobalt and chromium. All patients had the same titanium tibial base plates, and no patellae were resurfaced. Despite the lack of cobalt and chromium in the prostheses used in the control group, no statistically significant differences in serum cobalt and chromium ion levels were found between the groups. On the basis of these results there does not appear to be any significant rise in serum metal ion levels following total knee arthroplasty several years after implantation.