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Erschienen in: European Spine Journal 4/2013

01.04.2013 | Original Article

Prospective study on serum metal levels in patients with metal-on-metal lumbar disc arthroplasty

verfasst von: Matthew F. Gornet, J. K. Burkus, M. L. Harper, F. W. Chan, A. K. Skipor, J. J. Jacobs

Erschienen in: European Spine Journal | Ausgabe 4/2013

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Abstract

Purpose

Metal-on-metal total disc replacement is a recent alternative treatment for degenerative disc disease. Wear and corrosion of these implants can lead to local and systemic transport of metal debris. This prospective longitudinal study examined the serum chromium and cobalt levels in 24 patients with cobalt–chromium alloy metal-on-metal lumbar disc replacements.

Methods

Serum was assayed for chromium (Cr) and cobalt (Co) using high-resolution inductively-coupled plasma-mass spectrometry. Detection limits were 0.015 ng/mL for Cr and 0.04 ng/mL for Co.

Results

Median serum Co levels at pre-op, 3, 6, 12, 24, and 36-months post-op were 0.10, 1.03, 0.96, 0.98, 0.67, and 0.52 ng/mL, respectively. Median serum Cr levels were 0.06, 0.49, 0.65, 0.43, 0.52, and 0.50 ng/mL, respectively.

Conclusion

In general, these results indicated that serum Co and Cr levels are elevated at all postoperative time points and are of the same order of magnitude as those observed in well-functioning metal-on-metal surface replacements of the hip and in metal-on-metal total hip replacements at similar postoperative time points.
Fußnoten
1
Cases with values between 1.5 and 3 lengths from the upper or lower edge of the box are defined as outlier. The box length is the interquartile range (25–75 %), (SPSS ver. 10.05).
 
2
Cases with values more than three box lengths from the upper or lower edge of the box are defined as extreme. The box length is the interquartile range (25–75 %), (SPSS ver. 10.05).
 
Literatur
1.
Zurück zum Zitat Gamradt SC, Wang JC (2005) Lumbar disc arthroplasty. Spine J 51:95–103CrossRef Gamradt SC, Wang JC (2005) Lumbar disc arthroplasty. Spine J 51:95–103CrossRef
2.
Zurück zum Zitat Bao QB, McCullen GM, Higham PA, Dumbleton JH, Yuan HA (1996) The artificial disc: theory, design and materials. Biomaterials 1712:1157–1167CrossRef Bao QB, McCullen GM, Higham PA, Dumbleton JH, Yuan HA (1996) The artificial disc: theory, design and materials. Biomaterials 1712:1157–1167CrossRef
3.
Zurück zum Zitat Guyer RD, McAfee PC, Hochschuler SH, Blumenthal SL, Fedder IL, Ohnmeiss DD, Cunningham BW (2004) Prospective randomized study of the charite artificial disc: data from two investigational centers. Spine J 46(Suppl):252S–259SCrossRef Guyer RD, McAfee PC, Hochschuler SH, Blumenthal SL, Fedder IL, Ohnmeiss DD, Cunningham BW (2004) Prospective randomized study of the charite artificial disc: data from two investigational centers. Spine J 46(Suppl):252S–259SCrossRef
4.
Zurück zum Zitat Zigler J, Delamarter R, Spivak JM, Linovitz RJ, Danielson GO III, Haider TT, Cammisa F, Zuchermann J, Balderston R, Kitchel S, Foley K, Watkins R, Bradford D, Yue J, Yuan H, Herkowitz H, Geiger D, Bendo J, Peppers T, Sachs B, Girardi F, Kropf M, Goldstein J (2007) Results of the prospective, randomized, multicenter food and drug administration investigational device exemption study of the prodisc-l total disc replacement versus circumferential fusion for the treatment of 1-level degenerative disc disease. Spine (Phila Pa 1976) 3211:1155–1162CrossRef Zigler J, Delamarter R, Spivak JM, Linovitz RJ, Danielson GO III, Haider TT, Cammisa F, Zuchermann J, Balderston R, Kitchel S, Foley K, Watkins R, Bradford D, Yue J, Yuan H, Herkowitz H, Geiger D, Bendo J, Peppers T, Sachs B, Girardi F, Kropf M, Goldstein J (2007) Results of the prospective, randomized, multicenter food and drug administration investigational device exemption study of the prodisc-l total disc replacement versus circumferential fusion for the treatment of 1-level degenerative disc disease. Spine (Phila Pa 1976) 3211:1155–1162CrossRef
5.
Zurück zum Zitat Mathews HH, Lehuec J, Friesem T, Zdeblick T, Eisermann L (2004) Design rationale and biomechanics of maverick total disc arthroplasty with early clinical results. Spine J 46(Suppl):268S–275SCrossRef Mathews HH, Lehuec J, Friesem T, Zdeblick T, Eisermann L (2004) Design rationale and biomechanics of maverick total disc arthroplasty with early clinical results. Spine J 46(Suppl):268S–275SCrossRef
6.
Zurück zum Zitat Harris WH (2001) Wear and periprosthetic osteolysis: the problem. Clin Orthop Relat Res 393:66–70PubMedCrossRef Harris WH (2001) Wear and periprosthetic osteolysis: the problem. Clin Orthop Relat Res 393:66–70PubMedCrossRef
7.
Zurück zum Zitat van Ooij A, Kurtz SM, Stessels F, Noten H, van Rhijn L (2007) Polyethylene wear debris and long-term clinical failure of the charite disc prosthesis: a study of 4 patients. Spine (Phila Pa 1976) 322:223–229CrossRef van Ooij A, Kurtz SM, Stessels F, Noten H, van Rhijn L (2007) Polyethylene wear debris and long-term clinical failure of the charite disc prosthesis: a study of 4 patients. Spine (Phila Pa 1976) 322:223–229CrossRef
8.
Zurück zum Zitat Amstutz HC, Le Duff MJ, Campbell PA, Gruen TA, Wisk LE (2010) Clinical and radiographic results of metal-on-metal hip resurfacing with a minimum ten-year follow-up. J Bone Joint Surg Am 9216:2663–2671CrossRef Amstutz HC, Le Duff MJ, Campbell PA, Gruen TA, Wisk LE (2010) Clinical and radiographic results of metal-on-metal hip resurfacing with a minimum ten-year follow-up. J Bone Joint Surg Am 9216:2663–2671CrossRef
9.
Zurück zum Zitat Treacy RBC, McBryde CW, Shears E, Pynsent PB (2011) Birmingham hip resurfacing: a minimum follow-up of ten years. J Bone Joint Surg Br 931:27–33 Treacy RBC, McBryde CW, Shears E, Pynsent PB (2011) Birmingham hip resurfacing: a minimum follow-up of ten years. J Bone Joint Surg Br 931:27–33
10.
Zurück zum Zitat Sieber HP, Rieker CB, Kottig P (1999) Analysis of 118 second-generation metal-on-metal retrieved hip implants. J Bone Joint Surg Br 811:46–50CrossRef Sieber HP, Rieker CB, Kottig P (1999) Analysis of 118 second-generation metal-on-metal retrieved hip implants. J Bone Joint Surg Br 811:46–50CrossRef
11.
Zurück zum Zitat Pandit H, Glyn-Jones S, McLardy-Smith P, Gundle R, Whitwell D, Gibbons CLM, Ostlere S, Athanasou N, Gill HS, Murray DW (2008) Pseudotumours associated with metal-on-metal hip resurfacings. J Bone Joint Surg Br 907:847–851 Pandit H, Glyn-Jones S, McLardy-Smith P, Gundle R, Whitwell D, Gibbons CLM, Ostlere S, Athanasou N, Gill HS, Murray DW (2008) Pseudotumours associated with metal-on-metal hip resurfacings. J Bone Joint Surg Br 907:847–851
12.
Zurück zum Zitat Korovessis P, Petsinis G, Repanti M, Repantis T (2006) Metallosis after contemporary metal-on-metal total hip arthroplasty: five to nine-year follow-up. J Bone Joint Surg Am 886:1183–1191CrossRef Korovessis P, Petsinis G, Repanti M, Repantis T (2006) Metallosis after contemporary metal-on-metal total hip arthroplasty: five to nine-year follow-up. J Bone Joint Surg Am 886:1183–1191CrossRef
13.
Zurück zum Zitat Skipor AK, Campbell PA, Patterson LM, Anstutz HC, Schmalzried TP, Jacobs JJ (2002) Serum and urine metal levels in patients with metal-on-metal surface arthroplasty. J Mater Sci Mater Med 1312:1227–1234CrossRef Skipor AK, Campbell PA, Patterson LM, Anstutz HC, Schmalzried TP, Jacobs JJ (2002) Serum and urine metal levels in patients with metal-on-metal surface arthroplasty. J Mater Sci Mater Med 1312:1227–1234CrossRef
14.
Zurück zum Zitat MacDonald SJ, McCalden RW, Chess DG, Bourne RB, Rorabeck CH, Cleland D, Leung F (2003) Metal-on-metal versus polyethylene in hip arthroplasty: a randomized clinical trial. Clin Orthop Relat Res 406:282–296PubMedCrossRef MacDonald SJ, McCalden RW, Chess DG, Bourne RB, Rorabeck CH, Cleland D, Leung F (2003) Metal-on-metal versus polyethylene in hip arthroplasty: a randomized clinical trial. Clin Orthop Relat Res 406:282–296PubMedCrossRef
15.
Zurück zum Zitat Garbuz DS, Tanzer M, Greidanus NV, Masri BA, Duncan CP (2010) The john charnley award: metal-on-metal hip resurfacing versus large-diameter head metal-on-metal total hip arthroplasty: a randomized clinical trial. Clin Orthop Relat Res 4682:318–325CrossRef Garbuz DS, Tanzer M, Greidanus NV, Masri BA, Duncan CP (2010) The john charnley award: metal-on-metal hip resurfacing versus large-diameter head metal-on-metal total hip arthroplasty: a randomized clinical trial. Clin Orthop Relat Res 4682:318–325CrossRef
16.
Zurück zum Zitat Langton DJ, Sprowson AP, Joyce TJ, Reed M, Carluke I, Partington P, Nargol AVF (2009) Blood metal ion concentrations after hip resurfacing arthroplasty: a comparative study of articular surface replacement and birmingham hip resurfacing arthroplasties. J Bone Joint Surg Br 9110:1287–1295 Langton DJ, Sprowson AP, Joyce TJ, Reed M, Carluke I, Partington P, Nargol AVF (2009) Blood metal ion concentrations after hip resurfacing arthroplasty: a comparative study of articular surface replacement and birmingham hip resurfacing arthroplasties. J Bone Joint Surg Br 9110:1287–1295
17.
Zurück zum Zitat MacDonald SJ, Brodner W, Jacobs JJ (2004) A consensus paper on metal ions in metal-on-metal hip arthroplasties. J Arthroplasty 198(Suppl 3):12–16CrossRef MacDonald SJ, Brodner W, Jacobs JJ (2004) A consensus paper on metal ions in metal-on-metal hip arthroplasties. J Arthroplasty 198(Suppl 3):12–16CrossRef
18.
Zurück zum Zitat Kim Y, Kassab F, Berven SH, Zurakowski D, Hresko MT, Emans JB, Kasser JR (2005) Serum levels of nickel and chromium after instrumented posterior spinal arthrodesis. Spine (Phila Pa 1976) 308:923–926CrossRef Kim Y, Kassab F, Berven SH, Zurakowski D, Hresko MT, Emans JB, Kasser JR (2005) Serum levels of nickel and chromium after instrumented posterior spinal arthrodesis. Spine (Phila Pa 1976) 308:923–926CrossRef
19.
Zurück zum Zitat del Rio J, Beguiristain J, Duart J (2007) Metal levels in corrosion of spinal implants. Eur Spine J 167:1055–1061CrossRef del Rio J, Beguiristain J, Duart J (2007) Metal levels in corrosion of spinal implants. Eur Spine J 167:1055–1061CrossRef
20.
Zurück zum Zitat McPhee IB, Swanson CE (2007) Metal ion levels in patients with stainless steel spinal instrumentation. Spine (Phila Pa 1976) 3218:1963–1968CrossRef McPhee IB, Swanson CE (2007) Metal ion levels in patients with stainless steel spinal instrumentation. Spine (Phila Pa 1976) 3218:1963–1968CrossRef
21.
Zurück zum Zitat Rackham MD, Cundy TP, Antoniou G, Freeman BJC, Sutherland LM, Cundy PJ (2010) Predictors of serum chromium levels after stainless steel posterior spinal instrumentation for adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 359:975–982CrossRef Rackham MD, Cundy TP, Antoniou G, Freeman BJC, Sutherland LM, Cundy PJ (2010) Predictors of serum chromium levels after stainless steel posterior spinal instrumentation for adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 359:975–982CrossRef
22.
Zurück zum Zitat Cundy TP, Delaney CL, Rackham MD, Antoniou G, Oakley AP, Freeman BJC, Sutherland LM, Cundy PJ (2010) Chromium ion release from stainless steel pediatric scoliosis instrumentation. Spine (Phila Pa 1976) 359:967–974CrossRef Cundy TP, Delaney CL, Rackham MD, Antoniou G, Oakley AP, Freeman BJC, Sutherland LM, Cundy PJ (2010) Chromium ion release from stainless steel pediatric scoliosis instrumentation. Spine (Phila Pa 1976) 359:967–974CrossRef
23.
Zurück zum Zitat Kasai Y, Iida R, Uchida A (2003) Metal concentrations in the serum and hair of patients with titanium alloy spinal implants. Spine (Phila Pa 1976) 2812:1320–1326 Kasai Y, Iida R, Uchida A (2003) Metal concentrations in the serum and hair of patients with titanium alloy spinal implants. Spine (Phila Pa 1976) 2812:1320–1326
24.
Zurück zum Zitat Richardson TD, Pineda SJ, Strenge KB, Van Fleet TA, MacGregor M, Milbrandt JC, Espinosa JA, Freitag P (2008) Serum titanium levels after instrumented spinal arthrodesis. Spine (Phila Pa 1976) 337:792–796CrossRef Richardson TD, Pineda SJ, Strenge KB, Van Fleet TA, MacGregor M, Milbrandt JC, Espinosa JA, Freitag P (2008) Serum titanium levels after instrumented spinal arthrodesis. Spine (Phila Pa 1976) 337:792–796CrossRef
25.
Zurück zum Zitat Zeh A, Planert M, Siegert G, Lattke P, Held A, Hein W (2007) Release of cobalt and chromium ions into the serum following implantation of the metal-on-metal maverick-type artificial lumbar disc (medtronic sofamor danek). Spine (Phila Pa 1976) 323:348–352CrossRef Zeh A, Planert M, Siegert G, Lattke P, Held A, Hein W (2007) Release of cobalt and chromium ions into the serum following implantation of the metal-on-metal maverick-type artificial lumbar disc (medtronic sofamor danek). Spine (Phila Pa 1976) 323:348–352CrossRef
26.
Zurück zum Zitat Zeh A, Becker C, Planert M, Lattke P, Wohlrab D (2009) Time-dependent release of cobalt and chromium ions into the serum following implantation of the metal-on-metal maverick type artificial lumbar disc (medtronic sofamor danek). Arch Orthop Trauma Surg 1296:741–746CrossRef Zeh A, Becker C, Planert M, Lattke P, Wohlrab D (2009) Time-dependent release of cobalt and chromium ions into the serum following implantation of the metal-on-metal maverick type artificial lumbar disc (medtronic sofamor danek). Arch Orthop Trauma Surg 1296:741–746CrossRef
27.
Zurück zum Zitat Stieber JR, Errico TJ, Bauer T, Whitaker C, Miz G, Sasso R (2010) Blood metal ion levels following implantation of the all-metal flexicore lumbar intervertebral disc replacement, 24–36 month follow-up. In: 10th Annual Global Symposium on Motion Preservation Technology,Spine Arthroplasty Society, New Orleans, LA, April 2010 Stieber JR, Errico TJ, Bauer T, Whitaker C, Miz G, Sasso R (2010) Blood metal ion levels following implantation of the all-metal flexicore lumbar intervertebral disc replacement, 24–36 month follow-up. In: 10th Annual Global Symposium on Motion Preservation Technology,Spine Arthroplasty Society, New Orleans, LA, April 2010
28.
Zurück zum Zitat ASTM 1537-08: Standard specification for wrought cobalt-28 chromium-6 molybdenum alloys for surgical implants ASTM 1537-08: Standard specification for wrought cobalt-28 chromium-6 molybdenum alloys for surgical implants
29.
Zurück zum Zitat Gornet MF, Burkus JK, Dryer RF, Peloza JH (2011) Lumbar disc arthroplasty with MAVERICK disc versus stand-alone interbody fusion: a prospective, randomized, controlled, multicenter investigational device exemption trial. Spine (Phila Pa 1976) 3625:E1600–E1611CrossRef Gornet MF, Burkus JK, Dryer RF, Peloza JH (2011) Lumbar disc arthroplasty with MAVERICK disc versus stand-alone interbody fusion: a prospective, randomized, controlled, multicenter investigational device exemption trial. Spine (Phila Pa 1976) 3625:E1600–E1611CrossRef
30.
Zurück zum Zitat Obot IB, Obi-Egbedi NO, Umoren SA (2009) Adsorption characteristics and corrosion inhibitive properties of Clotrimazole for aluminium corrosion in hydrochloric acid. Int J Electrochem Sci 4:863–877 Obot IB, Obi-Egbedi NO, Umoren SA (2009) Adsorption characteristics and corrosion inhibitive properties of Clotrimazole for aluminium corrosion in hydrochloric acid. Int J Electrochem Sci 4:863–877
31.
Zurück zum Zitat Eddy NO, Ebenso EE (2010) Adsorption and quantum chemical studies on cloxacillin and halides for the corrosion of mild steel in acidic medium Int. J. Electrochem. Sci. 5:731–750 Eddy NO, Ebenso EE (2010) Adsorption and quantum chemical studies on cloxacillin and halides for the corrosion of mild steel in acidic medium Int. J. Electrochem. Sci. 5:731–750
32.
Zurück zum Zitat Jacobs JJ, Skipor AK, Black J, Urban R, Galante JO (1991) Release and excretion of metal in patients who have a total hip-replacement component made of titanium-base alloy. J Bone Joint Surg Am 7310:1475–1486 Jacobs JJ, Skipor AK, Black J, Urban R, Galante JO (1991) Release and excretion of metal in patients who have a total hip-replacement component made of titanium-base alloy. J Bone Joint Surg Am 7310:1475–1486
33.
Zurück zum Zitat Bisseling P, Zeilstra DJ, Hol AM, van Susante JLC (2011) Metal ion levels in patients with a lumbar metal-on-metal total disc replacement: should we be concerned? J Bone Joint Surg Br 937:949–954 Bisseling P, Zeilstra DJ, Hol AM, van Susante JLC (2011) Metal ion levels in patients with a lumbar metal-on-metal total disc replacement: should we be concerned? J Bone Joint Surg Br 937:949–954
34.
Zurück zum Zitat Clark M, Prentice J, Hoggard N, Stockley I, Jacobs JJ, Wilkinson JM (2012) Effect of laboratory analysis on metal levels after momhr and potential impact on patient management and interpretation of research datasets. In: Transactions of the 58th Annual Meeting of the Orthopaedic Research Society, Poster #1928 Clark M, Prentice J, Hoggard N, Stockley I, Jacobs JJ, Wilkinson JM (2012) Effect of laboratory analysis on metal levels after momhr and potential impact on patient management and interpretation of research datasets. In: Transactions of the 58th Annual Meeting of the Orthopaedic Research Society, Poster #1928
35.
Zurück zum Zitat Villarraga ML, Cripton PA, Teti SD, Steffey DL, Krisnamuthy S, Albert T, Hilibrand A, Vaccaro A (2006) Wear and corrosion in retrieved thoracolumbar posterior internal fixation. Spine (Phila Pa 1976) 31:2454–2462CrossRef Villarraga ML, Cripton PA, Teti SD, Steffey DL, Krisnamuthy S, Albert T, Hilibrand A, Vaccaro A (2006) Wear and corrosion in retrieved thoracolumbar posterior internal fixation. Spine (Phila Pa 1976) 31:2454–2462CrossRef
36.
Zurück zum Zitat Harper ML, Dooris A, Pare PE (2009) The fundamentals of biotribology and its application to spine arthroplasty. SAS J 3:125–132CrossRef Harper ML, Dooris A, Pare PE (2009) The fundamentals of biotribology and its application to spine arthroplasty. SAS J 3:125–132CrossRef
37.
Zurück zum Zitat Witzleb W, Ziegler J, Krummenauer F, Neumeister V, Guenther K (2006) Exposure to chromium, cobalt and molybdenum from metal-on-metal total hip replacement and hip resurfacing arthroplasty. Acta Orthop 775:697–705CrossRef Witzleb W, Ziegler J, Krummenauer F, Neumeister V, Guenther K (2006) Exposure to chromium, cobalt and molybdenum from metal-on-metal total hip replacement and hip resurfacing arthroplasty. Acta Orthop 775:697–705CrossRef
38.
Zurück zum Zitat Back DL, Young DA, Shimmin AJ (2005) How do serum cobalt and chromium levels change after metal-on-metal hip resurfacing? Clin Orthop Relat Res 438:177–181PubMedCrossRef Back DL, Young DA, Shimmin AJ (2005) How do serum cobalt and chromium levels change after metal-on-metal hip resurfacing? Clin Orthop Relat Res 438:177–181PubMedCrossRef
39.
Zurück zum Zitat Skipor AK, Campbell PA, Gitelis S, Berger RA, Amstutz HC & Jacobs JJ (2004) Three year prospective study of serum and urine metal levels in patients with metal-on-metal total hip and surface arthroplasty. In: Transactions of the 50th Annual Meeting of the Orthopaedic Research Society, Paper 124 Skipor AK, Campbell PA, Gitelis S, Berger RA, Amstutz HC & Jacobs JJ (2004) Three year prospective study of serum and urine metal levels in patients with metal-on-metal total hip and surface arthroplasty. In: Transactions of the 50th Annual Meeting of the Orthopaedic Research Society, Paper 124
40.
Zurück zum Zitat Brodner W, Grubl A, Jankovsky R, Meisinger V, Lehr S, Gottsauner-Wolf F (2004) Cup inclination and serum concentration of cobalt and chromium after metal-on-metal total hip arthroplasty. J Arthroplasty 198(Suppl 3):66–70CrossRef Brodner W, Grubl A, Jankovsky R, Meisinger V, Lehr S, Gottsauner-Wolf F (2004) Cup inclination and serum concentration of cobalt and chromium after metal-on-metal total hip arthroplasty. J Arthroplasty 198(Suppl 3):66–70CrossRef
41.
Zurück zum Zitat Kwon YM, Thomas P, Summer B, Pandit H, Taylor A, Beard D, Murray DW, Gill HS (2010) Lymphocyte proliferation responses in patients with pseudotumors following metal-on-metal hip resurfacing arthroplasty. J Orthop Res 284:444–450 Kwon YM, Thomas P, Summer B, Pandit H, Taylor A, Beard D, Murray DW, Gill HS (2010) Lymphocyte proliferation responses in patients with pseudotumors following metal-on-metal hip resurfacing arthroplasty. J Orthop Res 284:444–450
42.
Zurück zum Zitat Guyer RD, Shellock J, MacLennan B, Hanscom D, Knight RQ, McCombe P, Jacobs JJ, Urban RM, Bradford D, Ohnmeiss DD (2011) Early failure of metal-on-metal artificial disc prostheses associated with lymphocytic reaction: diagnosis and treatment experience in four cases. Spine (Phila Pa 1976) 367:E492–E497CrossRef Guyer RD, Shellock J, MacLennan B, Hanscom D, Knight RQ, McCombe P, Jacobs JJ, Urban RM, Bradford D, Ohnmeiss DD (2011) Early failure of metal-on-metal artificial disc prostheses associated with lymphocytic reaction: diagnosis and treatment experience in four cases. Spine (Phila Pa 1976) 367:E492–E497CrossRef
43.
Zurück zum Zitat Berry MR, Peterson BG, Alander DH (2010) A granulomatous mass surrounding a maverick total disc replacement causing iliac vein occlusion and spinal stenosis: a case report. J Bone Joint Surg Am 925:1242–1245CrossRef Berry MR, Peterson BG, Alander DH (2010) A granulomatous mass surrounding a maverick total disc replacement causing iliac vein occlusion and spinal stenosis: a case report. J Bone Joint Surg Am 925:1242–1245CrossRef
44.
Zurück zum Zitat Francois J, Coessens R, Lauweryns P (2007) Early removal of a maverick disc prosthesis: surgical findings and morphological changes. Acta Orthop Belg 731:122–127 Francois J, Coessens R, Lauweryns P (2007) Early removal of a maverick disc prosthesis: surgical findings and morphological changes. Acta Orthop Belg 731:122–127
Metadaten
Titel
Prospective study on serum metal levels in patients with metal-on-metal lumbar disc arthroplasty
verfasst von
Matthew F. Gornet
J. K. Burkus
M. L. Harper
F. W. Chan
A. K. Skipor
J. J. Jacobs
Publikationsdatum
01.04.2013
Verlag
Springer-Verlag
Erschienen in
European Spine Journal / Ausgabe 4/2013
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-012-2581-8

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