Abstract
Aims: Limb sparing surgery, for selected cases of long bone primary malignancy, may be accomplished with the use of large prostheses. Conventional joint implants are known to release metal ions by corrosion or wear. The aim of this study was to determine if a specialist group of patients had elevated serum metal levels. Methods: Over a 12 month period, 20 patients who had undergone previous surgery were recruited from a bone tumour clinic. A 10ml venous blood sample was obtained and analysed for trace metals using a previously published mass-spectrometry technique. Results: Eight children (mean age 14.5 years) and 12 adults (mean age 46.5 years) were recruited a mean of 54 months and 86 months following surgery, respectively. Trace metal (aluminium, titanium, cobalt) elevation was observed in 5/8 (63%) paediatric cases and 6/12 (50%) adult cases. Three of the adults had signiþcantly raised levels, (≤ 50 times), and had undergone revision surgery for loosening. There was no observed implant loosening in the paediatric group. Conclusions: This small sample has demonstrated that many patients with long-term large tumour implants have trace metal levels below laboratory detection. Signiþcant elevation of metal levels in adults was associated with loosening or wear of implants. A signiþcant proportion of paediatric cases had slight elevations, but the signiþcance of this is unknown at present.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
