Correlation and diagnostic performance of metal ions in patients with pseudotumor after MoM hip arthroplasty: a systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#humans #arthroplasty-replacement-hip #chromium #cobalt #granuloma-plasma-cell

Correlation and diagnostic performance of metal ions in patients with pseudotumor after MoM hip arthroplasty: a systematic review and meta-analysis

Li et al., 2024 | J Orthop Surg Res | Meta Analysis

Citation

Li He-Xi, Zhang Qing-Yi, ... Xie Hui-Qi. Correlation and diagnostic performance of metal ions in patients with pseudotumor after MoM hip arthroplasty: a systematic review and meta-analysis. J Orthop Surg Res. 2024-Nov-05;19(1):723. doi:10.1186/s13018-024-05198-6

Abstract

BACKGROUND: The persistently rising complication, pseudotumor, after hip arthroplasty required surgeons' vigilance. Although the remaining controversial relationship between metal ions and pseudotumor, metal ion detection had been widely employed in clinic. The aim of this study is to evaluate the correlation between metal ions and pseudotumor, as well as the effectiveness of metal ion analysis in the screening and diagnosis of pseudotumor through systematic review and meta-analysis. METHODS: The Medline and Embase databases were searched for studies evaluating metal ions and patients with pseudotumors after hip arthroplasty. A systematic review of risk ratio and diagnostic performance for metal ions was conducted. RESULTS: Seven studies were included in the systematic review. The mean Methodological Index for Non-Randomized Studies (MINORS) score of the included studies was 19 (range, 14 to 22). Pooled risk ratio (RR) value was 2.01(95% CI: 1.25-3.24; P = 0.004) for cobalt ions level and 1.44 (95% CI: 1.10-1.88; P = 0.008) for chromium ions level. The pooled sensitivity, specificity and the area under the curve (AUC) for cobalt and chromium ions were determined to be 0.59, 0.82, 0.73 and 0.34, 0.82, 0.56, respectively. CONCLUSIONS: The metal ions level has a low diagnostic value. It is of certain value for confirmation, but should not be used as a routine screening indicator. The diagnostic value of cobalt ions is higher than that of chromium. LEVEL OF EVIDENCE: Diagnostic Level IV.

Key Findings

Seven studies were included in the systematic review. The mean Methodological Index for Non-Randomized Studies (MINORS) score of the included studies was 19 (range, 14 to 22). Pooled risk ratio (RR) value was 2.01(95% CI: 1.25-3.24; P = 0.004) for cobalt ions level and 1.44 (95% CI: 1.10-1.88; P = 0.008) for chromium ions level. The pooled sensitivity, specificity and the area under the curve (AUC) for cobalt and chromium ions were determined to be 0.59, 0.82, 0.73 and 0.34, 0.82, 0.56, respecti

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population pseudotumors after hip arthroplasty
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Arthroplasty, Replacement, Hip
  • Chromium
  • Cobalt
  • Granuloma, Plasma Cell
  • Hip Prosthesis
  • Ions
  • Metals
  • Postoperative Complications

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Systematic Review, Journal Article, Meta-Analysis
  • Vertical: chromium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09