DOI: https://doi.org/10.22141/1608-1706.6.19.2018.152216

Dynamics of the level of metals in the blood of patients with knee and hip osteoarthritis after the knee and hip replacement

F.V. Klimovitskiy, N.V. Sokrut, О.V. Syniachenko, O.P. Sokrut

Abstract


Background. Gonarthrosis and coxarthrosis are one of the most frequent orthopedic diseases that cause significant medical and social damage to sick people and society as a whole. Knee and hip osteoarthritis (KHO) is accompanied by microelementosis, which occurs with a violation in body levels of many metals. The study of the role of metals contained in the body of patients with KHO, with pathogenetic constructions of complications in the knee and hip replacement, has become an urgent problem. After the implantation of artificial metal joints in HCA, an increase in the levels of Al, Co, Cr, Mo, Ni, Ti, and V in periprosthetic tissues was detected. Purpose of the study: to assess the nature of the dynamics of the blood levels of metals (Al, Co, Cr, Mo, Ni, Ti, V) in patients with KHO before and after joint arthroplasty. Materials and methods. Unilateral arthroplasty was performed in 11 patients with KHO (7 women and 4 men aged 46–65 years). Artificial prostheses of the hip joints were implanted in 6 patients, knee joints — in 5. In two cases, cement fixation was applied. Before surgery, during sonography, manifested synovitis was detected in 8 cases, in 4 cases, there was stage IV of the disease, in 7 — III, osteochondrosis of the spine was diagnosed in 10 patients, spondyloarthritis of facet joints — in 5, systemic osteoporosis — in 4, polyarthrosis was detected in 6 patients. Results. The initial content (before implantation of artificial joints) of Al was 2.70 ± 0.45 µg/l, Co — 12.50 ± 1.52 µg/l, Cr — .50 ± 0.23 ng/l, Mo — 2.00 ± 0.28 µg/l, Ni — 5.20 ± 0.80 µg/l, Ti — 2.50 ± 0.17 µg/l, V — 1.90 ± 0.29 µg/l. In KHO, Co values turned out to be 1/2 higher than control values in the group of healthy individuals, Ti — 1/4 higher. Two­three months after arthroplasty, a significant increase was observed: by 89.1 % — in Co level, 75.2 % — Cr, 43.9 % — Mo, 49.4 % — Ni and 45.4 % — Ti (Co and Cr content became even higher — by 23.3 and 40.2 %, respectively, compared with the baseline values). There were correlations of the blood indicators with the parameters of metals in the hair and their level in the soil of the patients’ regions of residence, on which the clinical course of the disease depended. The risk factors for the significant bone­destructive changes and the accumulation of metals in the body of patients with KHO after arthroplasty are the soil indices of Co > 3 mg/kg, Cr > 260 mg/kg Ti > 520 mg/kg and V > 160 mg/kg. Conclusions. The progression of the existing microelements in KHO after implantation of artificial joints should be taken into account when planning the program of arthroplasty and predicting possible complications of the operation.


Keywords


osteoarthrosis; knee and hip joints; replacement; metals; blood

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