Cobalt, Synovial Fluid
Use
This test is useful for monitoring metallic prosthetic implant wear and local tissue destruction in failed hip arthroplasty constructs. Per FDA recommendations, it can be part of the clinical evaluation by measuring and following serial cobalt concentrations in patients with metal-on-metal hip implants. A recent study indicated that synovial fluid measurements were superior to whole blood and serum cobalt concentrations for predicting local tissue destruction in failed hip arthroplasty constructs.
Special Instructions
Only to be used in individuals with metallic prosthetic implants. The significance of cobalt concentrations in synovial fluid in patients without implants is unknown. Correct collection is critical due to the potential for contamination from cobalt in black rubber plunger seals of syringes. Use specific EDTA vacutainers for collection.
Limitations
This test is not suitable for assessing nutritional status or potential cobalt toxicity. Specimens should not be collected within 96 hours if the patient has been administered gadolinium- or iodine-containing contrast media due to potential interference. The radioactive form of cobalt (60Co) is not quantified. Elevated trace element concentrations do not independently predict prosthesis wear or failure without corroborating clinical information.
New York Approved
Methodology
Mass Spectrometry (ICP-MS)
Biomarkers
LOINC Codes
- 23842-8
- 23842-8
Result Turnaround Time
2-8 days
Related Documents
For more information, please review the documents below
Specimen
Body Fluid
Volume
1 mL
Minimum Volume
0.4 mL
Container
Royal blue-top BD vacutainer with EDTA
Collection Instructions
Avoid using syringes with black rubber plunger seals to prevent contamination. Follow metals analysis specimen collection and transport instructions.
Patient Preparation
Ensure a 96-hour interval post-exposure to gadolinium or iodine contrast media before collection.
Causes for Rejection
Specimens with gross hemolysis, lipemia, or icterus are acceptable.
Stability Requirements
| Temperature | Period |
|---|---|
| Room Temperature | 90 days |
| Refrigerated | 90 days |
| Frozen | 90 days |