| Web: | mayocliniclabs.com |
|---|---|
| Email: | mcl@mayo.edu |
| Telephone: | 800-533-1710 |
| International: | +1 855-379-3115 |
| Values are valid only on day of printing | |
| Web: | mayocliniclabs.com |
|---|---|
| Email: | mcl@mayo.edu |
| Telephone: | 800-533-1710 |
| International: | +1 855-379-3115 |
| Values are valid only on day of printing | |
Chromium and Cobalt
Answers from the Lab
Chromium and cobalt are elements often used in alloy to make some types of metal hip implants. In this test specific episode of the "Answers From the Lab" podcast, Paul Jannetto, Ph.D., describes Mayo Clinic Laboratories' new testing for these elements, which can indicate that a hip implant is malfunctioning.
"Tiny particles can wear off these metal-on-metal devices and ultimately get into the bloodstream," Dr. Jannetto says. "Over time, the metal particles can cause damage to the bone and tissue surrounding these implants — leading to a condition sometimes called adverse reaction to metal debris."
The FDA recommends that orthopedic surgeons measure chromium and cobalt in metal-on-metal hip implant in patients with symptoms of this adverse reaction. Specifically, the FDA recommends EDTA anticoagulated whole blood testing, which Mayo Clinic Laboratories offers.
However, a Mayo Clinic study has found that synovial fluid offers better sensitivity and specificity compared with whole blood or serum. The Metals Laboratory evaluated chromium and cobalt concentrates in EDTA whole blood, serum and synovial fluid collected from patients undergoing hip revision surgery at Mayo Clinic.
"In patients with adverse local tissue reaction, the synovial fluid cobalt and chromium concentrations were 120 and 414 times higher than whole blood chromium and cobalt concentrations, respectively," Dr. Jannetto says. "Based on our study, synovial fluid offers superior sensitivity and specificity to identify adverse reaction to metal debris in patients with metal-on-metal hip implants."
"If synovial fluid isn't available, EDTA whole blood is the next best specimen type for analysis of chromium and cobalt," Dr. Jannetto says.
Listen to learn more about how synovial fluid testing can provide more-sensitive detection of chromium and cobalt in individuals suspected of having malfunctioning hip implants.
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COSY | Cobalt, Synovial Fluid
CRSY | Chromium, Synovial Fluid
COSY | Cobalt, Synovial Fluid
CRCOF | Chromium and Cobalt, Synovial Fluid
CRSY | Chromium, Synovial Fluid
COSY | Cobalt, Synovial Fluid
Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metal tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for at least 96 hours.
Container/Tube: Royal blue top (metal-free EDTA)
Specimen Volume: 1 mL
Collection Instructions: See Trace Metals Analysis Specimen Collection and Transport in Special Instructions for complete instructions.
Additional Information: Cobalt is present in the black rubber plunger seals found in most disposable syringes. As a result, synovial fluid should not be collected in these devices as contamination may occur.
CRCOF | Chromium and Cobalt, Synovial Fluid
Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metal tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for at least 96 hours.
Container/Tube: Royal blue top (metal-free EDTA)
Specimen Volume: 1 mL
Collection Instructions: See Trace Metals Analysis Specimen Collection and Transport in Special Instructions for complete instructions.
Additional Information: Cobalt and chromium are present in the black rubber plunger seals found in most disposable syringes. As a result, synovial fluid should not be collected in these devices as contamination may occur.
CRSY | Chromium, Synovial Fluid
Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metal tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for at least 96 hours.
Container/Tube: Royal blue top (metal-free EDTA)
Specimen Volume: 1 mL
Collection Instructions: See Trace Metals Analysis Specimen Collection and Transport in Special Instructions for complete instructions.
Additional Information: Chromium is present in the black rubber plunger seals found in most disposable syringes. As a result, synovial fluid should not be collected in these devices as contamination may occur.
Analytic time: 2 to 8 days
Days performed: Wednesday
