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Chromium and Cobalt, Whole Blood

CPT: 82495; 83018
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Expected Turnaround Time

3 - 7 days


Specimen Requirements


Specimen

Whole blood


Volume

4 mL


Minimum Volume

0.5 mL


Container

Royal blue-top (EDTA) metal-free tube


Storage Instructions

Submission/transport (<3 days): Room temperature. For storage beyond three days, specimen should be refrigerated or frozen.


Test Details


Use

Detect metal ion accumulation caused by metal-on-metal (MoM) implants.


Methodology

Inductively coupled plasma/mass spectrometry (ICP/MS)


Reference Interval

Reference interval is for patients with metal-on-metal (MoM) orthopedic implants. An algorithm intended as an aid for orthopedic surgeons in the assessment and management of patients with metal-on-metal bearings was published in 2014.1

The systematic risk stratification includes recommendations for multiple modes of failure and stratifies patient risk groups based on a thorough clinical history, a detailed physical examination, radiographic tests, and laboratory tests, including measurement of metal ions (chromium and cobalt).

The following stratification applies to chromium or cobalt as individual analytes, not to the combined total.

• Low risk group: <3.0 ng/mL

• Moderate risk group: 3.0−10.0 ng/mL

• High risk group: >10.0 ng/mL

Metal ion tests are an important adjunct to systemic clinical assessment; however, metal ion levels alone should not be relied on as the sole parameter to determine clinical recommendations for revision surgery.


Footnotes

1. Kwon YM, Lombardi AV, Jacobs JJ, Fehring TK, Lewis CG, Cabanela ME. Risk stratification algorithm for management of patients with metal-on-metal hip arthroplasty: consensus statement of the American Association of Hip and Knee Surgeons, the American Academy of Orthopaedic Surgeons, and the Hip Society. J Bone Joint Surg Am. 2014 Jan 1; 96(1):e4. 24382732

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
738770 Chromium and Cobalt, WB (MoM) 738771 Chromium ng/mL 5619-2
738770 Chromium and Cobalt, WB (MoM) 738772 Cobalt ng/mL 5625-9

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