Chromium and Cobalt, Synovial Fluid
Use
The test is used for monitoring metallic prosthetic implant wear and local tissue destruction in failed hip arthroplasty constructs, particularly for individuals with chromium or cobalt implants. Synovial fluid measurements are often superior to whole blood and serum concentrations in predicting local tissue damage in failed hip replacements. Serial measurements of chromium and cobalt are recommended for symptomatic patients with metal-on-metal hip implants to predict adverse local tissue reactions.
Special Instructions
The test is not useful for assessing vitamin B12 activity. Ensure that high concentrations of gadolinium and iodine contrast media have not been administered within 96 hours prior to specimen collection, as they can interfere with test results.
Limitations
The test is not cleared or approved by the FDA but meets CLIA requirements. Chromium, present in the environment at significantly higher levels than biological tissues, can lead to external contamination reports. Special specimen collection tubes and ultra-clean techniques are essential for cobalt measurements. Elevated trace element levels should not solely predict prosthesis wear without clinical correlations. Radioactive cobalt (60Co) is not detected in this test.
New York Approved
Methodology
Mass Spectrometry (ICP-MS)
Biomarkers
LOINC Codes
- 95525-2
- 23842-8
- 95526-0
Result Turnaround Time
2-8 days
Related Documents
For more information, please review the documents below
Specimen
Other
Volume
1 mL
Minimum Volume
0.4 mL
Container
Royal blue-top BD vacutainer with EDTA blood collection tube (3 mL) (BD catalog no. 367777) (T989)
Collection Instructions
See Metals Analysis Specimen Collection and Transport for complete instructions.
Patient Preparation
Avoid specimen collection for at least 96 hours after gadolinium or iodine contrast media administration.
Causes for Rejection
Contamination due to cobalt and chromium in black rubber plunger seals in disposable syringes.
Stability Requirements
| Temperature | Period |
|---|---|
| Room Temperature | 90 days |
| Refrigerated | 90 days |
| Frozen | 90 days |