Should we routinely assess for serum/blood metal ion levels (cobalt (Co) and chromium (Cr)) when working up a patient with a painful total joint arthroplasty?

Authors: Paul Lachiewicz, Brett Levine, Daniel Schweitzer, Ianiv Klaber, Francisco Bengoa

RECOMMENDATION: There is no data to suggest routine assessment of serum/blood metal ion levels (CoCr) in all patients with painful joint arthroplasty. There may be a rationale for second-line assessment of metal levels in painful metal-on-metal (MoM) total hip arthroplasty (THA), hip resurfacing, modular neck femoral components and in certain metal-on-polyethylene (MoP) THA in which trunnion corrosion is suspected.

LEVEL OF EVIDENCE: Limited

DELEGATE VOTE: Agree: 92%, Disagree: 4%, Abstain: 4% (Super Majority, Strong Consensus)