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Metal-on-metal hip implants affect cobalt and chromium levels in sperm, study finds
Though the meaning of the findings is not yet fully understood, the subject warrants further study.
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Sperm parameters of young total hip arthroplasty patients with metal-on-metal prostheses are not significantly affected, though study results strongly suggest that both cobalt and chromium ions cross over into semen at low concentrations.
Vassilios S. Nikolau, MD, PhD, presented the results of his team’s study at the 2010 EFORT Congress, here.
“There are concerns associated with metal-on-metal hip implants with the production of metal ions,” Nikolau said.
Nikolau’s team collected semen from 10 total hip arthroplasty patients between 41 and 49 years old and examined for morphology, motility and number of sperm cells. All of the patients were reportedly doing well at their follow-up visits, and no sign of osteolysis was found on X-rays.
Methods
Cobalt and chromium concentrations were measured in both the seminal plasma and the blood of patients by inductively coupled plasma-mass spectroscopy, the study noted.
According to the study results, cobalt levels in the seminal plasma and blood of the patients were not statistically different. Chromium levels, however, were significantly lower in the seminal plasma than in the blood of the patients. Ejaculate volume, sperm density, total sperm count, pH and percentage of normal morphology were all reported as being within the range of the World Health Organization criteria for a fertile population.
Viability a concern
Viability, however, was lower than that observed in a fertile population without prostheses — “a point of concern,” Nikolau said.
Nikolau concluded by saying that further longitudinal studies were needed to conclusively determine the effect of metal ions from metal-on-metal prostheses on sperm parameters.
“The clinical significance is still unknown, and I think we need to investigate that,” he said.– by Robert Press
Reference:
- Nikolau VS, Petit A, Zukor D, et al. Semen metal ion levels and sperm quality in patients with metal on metal total hip replacement. Paper #F501. Presented at the 2010 EFORT Congress. June 2-5. Madrid.
- Vassilios S. Nikolau, MD, PhD, can be reached at Athens University, 2nd Orthopedic Department, Megalou Alexandrou 54, Maroussi, Athens, Greece, PC 15124; e-mail: vassilios.nikolaou@gmail.com.
