Elevated serum titanium level as a marker for failure in a titanium modular fluted tapered stem

Ian P. McAlister, Matthew Abdel

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Serum ion concentrations of cobalt and chromium are commonly used to monitor for the development of local metal reactions in metal-on-metal total hip arthroplasties as well as dual-modular constructs. Although rarely used in clinical practice elevated serum titanium levels have the ability to indicate a failure with contemporary revision constructs such as with titanium modular fluted tapered (TMFT) stems. The authors report the case of a 64-year-old man with a TMFT stem after revision total hip arthroplasty for a dual-modular neck construct who had set screw disengagement with subsequent proximal body loosening. The patient's serum cobalt and chromium levels were normal but he had a markedly elevated serum titanium level indicating failure of the titanium modular junction. Implant failures at modular junctions in femoral components are well described. Although several different failure mechanisms have been defined to the authors' knowledge this is the first reported failure of this particular TMFT stem. In addition this is the first report describing the use of serum titanium levels in identifying a novel failure mechanism. With the popularity of this stem surgeons should be aware that an elevated serum titanium level may aid in the diagnosis of this unique complication.

Original languageEnglish (US)
Pages (from-to)e768-e770
JournalOrthopedics
Volume39
Issue number4
DOIs
StatePublished - Jul 1 2016

Fingerprint

Titanium
Serum
Metals
Chromium
Cobalt
Arthroplasty
Hip
Thigh
Neck
Ions

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Elevated serum titanium level as a marker for failure in a titanium modular fluted tapered stem. / McAlister, Ian P.; Abdel, Matthew.

In: Orthopedics, Vol. 39, No. 4, 01.07.2016, p. e768-e770.

Research output: Contribution to journalArticle

@article{e35e64f13a554ead96483d44d3167714,
title = "Elevated serum titanium level as a marker for failure in a titanium modular fluted tapered stem",
abstract = "Serum ion concentrations of cobalt and chromium are commonly used to monitor for the development of local metal reactions in metal-on-metal total hip arthroplasties as well as dual-modular constructs. Although rarely used in clinical practice elevated serum titanium levels have the ability to indicate a failure with contemporary revision constructs such as with titanium modular fluted tapered (TMFT) stems. The authors report the case of a 64-year-old man with a TMFT stem after revision total hip arthroplasty for a dual-modular neck construct who had set screw disengagement with subsequent proximal body loosening. The patient's serum cobalt and chromium levels were normal but he had a markedly elevated serum titanium level indicating failure of the titanium modular junction. Implant failures at modular junctions in femoral components are well described. Although several different failure mechanisms have been defined to the authors' knowledge this is the first reported failure of this particular TMFT stem. In addition this is the first report describing the use of serum titanium levels in identifying a novel failure mechanism. With the popularity of this stem surgeons should be aware that an elevated serum titanium level may aid in the diagnosis of this unique complication.",
author = "McAlister, {Ian P.} and Matthew Abdel",
year = "2016",
month = "7",
day = "1",
doi = "10.3928/01477447-20160503-02",
language = "English (US)",
volume = "39",
pages = "e768--e770",
journal = "Orthopedics",
issn = "0147-7447",
publisher = "Slack Incorporated",
number = "4",

}

TY - JOUR

T1 - Elevated serum titanium level as a marker for failure in a titanium modular fluted tapered stem

AU - McAlister, Ian P.

AU - Abdel, Matthew

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Serum ion concentrations of cobalt and chromium are commonly used to monitor for the development of local metal reactions in metal-on-metal total hip arthroplasties as well as dual-modular constructs. Although rarely used in clinical practice elevated serum titanium levels have the ability to indicate a failure with contemporary revision constructs such as with titanium modular fluted tapered (TMFT) stems. The authors report the case of a 64-year-old man with a TMFT stem after revision total hip arthroplasty for a dual-modular neck construct who had set screw disengagement with subsequent proximal body loosening. The patient's serum cobalt and chromium levels were normal but he had a markedly elevated serum titanium level indicating failure of the titanium modular junction. Implant failures at modular junctions in femoral components are well described. Although several different failure mechanisms have been defined to the authors' knowledge this is the first reported failure of this particular TMFT stem. In addition this is the first report describing the use of serum titanium levels in identifying a novel failure mechanism. With the popularity of this stem surgeons should be aware that an elevated serum titanium level may aid in the diagnosis of this unique complication.

AB - Serum ion concentrations of cobalt and chromium are commonly used to monitor for the development of local metal reactions in metal-on-metal total hip arthroplasties as well as dual-modular constructs. Although rarely used in clinical practice elevated serum titanium levels have the ability to indicate a failure with contemporary revision constructs such as with titanium modular fluted tapered (TMFT) stems. The authors report the case of a 64-year-old man with a TMFT stem after revision total hip arthroplasty for a dual-modular neck construct who had set screw disengagement with subsequent proximal body loosening. The patient's serum cobalt and chromium levels were normal but he had a markedly elevated serum titanium level indicating failure of the titanium modular junction. Implant failures at modular junctions in femoral components are well described. Although several different failure mechanisms have been defined to the authors' knowledge this is the first reported failure of this particular TMFT stem. In addition this is the first report describing the use of serum titanium levels in identifying a novel failure mechanism. With the popularity of this stem surgeons should be aware that an elevated serum titanium level may aid in the diagnosis of this unique complication.

UR - http://www.scopus.com/inward/record.url?scp=84980417113&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84980417113&partnerID=8YFLogxK

U2 - 10.3928/01477447-20160503-02

DO - 10.3928/01477447-20160503-02

M3 - Article

C2 - 27158825

AN - SCOPUS:84980417113

VL - 39

SP - e768-e770

JO - Orthopedics

JF - Orthopedics

SN - 0147-7447

IS - 4

ER -