{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T07:33:06Z","timestamp":1782977586844,"version":"3.54.5"},"reference-count":44,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2015,6,6]],"date-time":"2015-06-06T00:00:00Z","timestamp":1433548800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["HIP International"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To determine whether gender, femoral head size, acetabular inclination, and time since surgery predicted high blood metal ion concentrations following Birmingham Hip Resurfacing (BHR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>BHR patients with unilateral bearings at one specialist centre with blood cobalt and chromium concentrations measured up to May 2013 were included. This comprised a mixed (at-risk) group including symptomatic patients and asymptomatic individuals with specific clinical and\/or radiological findings. Blood sampling was at a mean of 7.5 years (range 1-15.4 years) postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 319 patients (mean age 49.3 years; 53% male), blood metal ions greater than 7 \u00b5g\/l were observed in 9% (n = 28). Blood metal ions were significantly higher in females (p&lt;0.001), femoral head sizes \u226448 mm (p&lt;0.01), and cup inclinations &gt;55\u00b0 (p&lt;0.001). Linear regression demonstrated femoral head size was responsible for the highest proportion of variance in blood metal ions (cobalt p&lt;0.001, R\n                      <jats:sup>2<\/jats:sup>\n                      = 8%; chromium p&lt;0.001, R\n                      <jats:sup>2<\/jats:sup>\n                      = 11%). Analysis of femoral head size and inclination together demonstrated 36% of BHRs with head sizes of 38-44 mm and inclination &gt;55\u00b0 had blood metal ions &gt;7 \u00b5g\/l. BHR 10-year survival for this at-risk group was 91% (95% confidence intervals 86.0%-95.0%) with 30 hips revised.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>If blood metal ions are used to screen hip resurfacing patients for adverse reactions to metal debris it is recommended those with small femoral head sizes (38-44 mm) and high acetabular inclinations (&gt;55\u00b0) are targeted. These findings require validation in other cohorts as they may not be applicable to all hip resurfacing devices given the differences in radial clearance, coverage arc, and metallurgy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5301\/hipint.5000258","type":"journal-article","created":{"date-parts":[[2015,6,25]],"date-time":"2015-06-25T06:29:40Z","timestamp":1435213780000},"page":"510-519","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Predicting High Blood Metal Ion Concentrations following Hip Resurfacing"],"prefix":"10.1177","volume":"25","author":[{"given":"Gulraj S.","family":"Matharu","sequence":"first","affiliation":[{"name":"Arthroplasty Department, The Royal Orthopaedic Hospital, Birmingham - UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Berryman","sequence":"additional","affiliation":[{"name":"Arthroplasty Department, The Royal Orthopaedic Hospital, Birmingham - UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley","family":"Brash","sequence":"additional","affiliation":[{"name":"Arthroplasty Department, The Royal Orthopaedic Hospital, Birmingham - UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul B.","family":"Pynsent","sequence":"additional","affiliation":[{"name":"Arthroplasty Department, The Royal Orthopaedic Hospital, Birmingham - UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronan B.C.","family":"Treacy","sequence":"additional","affiliation":[{"name":"Arthroplasty Department, The Royal Orthopaedic Hospital, Birmingham - UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Dunlop","sequence":"additional","affiliation":[{"name":"Arthroplasty Department, The Royal Orthopaedic Hospital, Birmingham - UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,6,6]]},"reference":[{"key":"bibr1-hipint.5000258","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2010.12.005"},{"key":"bibr2-hipint.5000258","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.94B3.28185"},{"key":"bibr3-hipint.5000258","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.94B9.29462"},{"key":"bibr4-hipint.5000258","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.95B9.31711"},{"key":"bibr5-hipint.5000258","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.95B10.32022"},{"key":"bibr6-hipint.5000258","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.92B10.23504"},{"key":"bibr7-hipint.5000258","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.93B2.25099"},{"key":"bibr8-hipint.5000258","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2011.01.003"},{"key":"bibr9-hipint.5000258","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.91B8.22562"},{"key":"bibr10-hipint.5000258","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-013-2979-6"},{"key":"bibr11-hipint.5000258","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.93B4.26429"},{"key":"bibr12-hipint.5000258","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.25.2000148"},{"key":"bibr13-hipint.5000258","unstructured":"Medical and Healthcare products Regulatory Agency (MHRA) (2012). 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