TY - JOUR
T1 - Challenges in the Measurement and Interpretation of Serum Titanium Concentrations
AU - Yao, Jie J.
AU - Lewallen, Eric A.
AU - Thaler, Roman
AU - Dudakovic, Amel
AU - Wermers, Michelle
AU - Day, Patrick
AU - Eckdahl, Steve
AU - Jannetto, Paul
AU - Bornhorst, Joshua A.
AU - Larson, A. Noelle
AU - Abdel, Matthew P.
AU - Lewallen, David G.
AU - van Wijnen, Andre J.
N1 - Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - The measurement of circulating metal ion levels in total hip arthroplasty patients continues to be an area of clinical interest. National regulatory agencies have recommended measurement of circulating cobalt and chromium concentrations in metal-on-metal bearing symptomatic total hip arthroplasty patients. However, the clinical utility of serum titanium (Ti) measurements is less understood due to wide variations in reported values and methodology. Fine-scale instrumentation for detecting in situ Ti levels continues to improve and has transitioned from graphite furnace atomic absorption spectroscopy to inductively coupled plasma optical emission spectrometry or inductively coupled plasma mass spectrometry. Additionally, analytical interferences, variable sample types, and non-standardized sample collection methods complicate Ti measurement and underlie the wide variation in reported levels. Normal reference ranges and pathologic ranges for Ti levels remain to be established quantitatively. However, before these ranges can be recognized and implemented, methodological standardization is necessary. This paper aims to provide background and recommendations regarding the complexities of measurement and interpretation of circulating Ti levels in total hip arthroplasty patients.
AB - The measurement of circulating metal ion levels in total hip arthroplasty patients continues to be an area of clinical interest. National regulatory agencies have recommended measurement of circulating cobalt and chromium concentrations in metal-on-metal bearing symptomatic total hip arthroplasty patients. However, the clinical utility of serum titanium (Ti) measurements is less understood due to wide variations in reported values and methodology. Fine-scale instrumentation for detecting in situ Ti levels continues to improve and has transitioned from graphite furnace atomic absorption spectroscopy to inductively coupled plasma optical emission spectrometry or inductively coupled plasma mass spectrometry. Additionally, analytical interferences, variable sample types, and non-standardized sample collection methods complicate Ti measurement and underlie the wide variation in reported levels. Normal reference ranges and pathologic ranges for Ti levels remain to be established quantitatively. However, before these ranges can be recognized and implemented, methodological standardization is necessary. This paper aims to provide background and recommendations regarding the complexities of measurement and interpretation of circulating Ti levels in total hip arthroplasty patients.
KW - Inductively coupled plasma–mass spectrometry
KW - Serum metal ion levels
KW - Titanium
KW - Total hip arthroplasty
KW - Total joint arthroplasty
KW - Total knee arthroplasty
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U2 - 10.1007/s12011-019-01891-4
DO - 10.1007/s12011-019-01891-4
M3 - Article
C2 - 31696354
AN - SCOPUS:85074860956
SN - 0163-4984
VL - 196
SP - 20
EP - 26
JO - Biological Trace Element Research
JF - Biological Trace Element Research
IS - 1
ER -