Serum metal levels after minimally invasive repair of pectus excavatum.

Abstract

BACKGROUND:

Metal implants may wear and corrode, resulting in systemic dissemination of metallic debris that is measurable in serum. Concern exists regarding adverse health effects related to implant-derived debris. Minimally invasive repair of pectus excavatum (MIRPE) is a popular technique in which a stainless steel substernal bar is implanted to achieve deformity correction. Serum metal levels have not previously been investigated after MIRPE.

METHODS:

Serum chromium, molybdenum, and nickel levels were measured in this cross-sectional study of 11 children implanted with pectus bars after MIRPE. Samples were analyzed using high-resolution inductively coupled plasma mass spectrometry.

RESULTS:

Median serum chromium and nickel values were elevated 3.3-fold (P = .0003) and 2.3-fold (P = .25), respectively, compared with age-matched controls. Serum chromium and nickel levels were abnormally elevated in 6 (55%) of 11 and 5 (45%) of 11, respectively. In patients whom postexplantation metal levels were measured, previously elevated levels were lowered. Serum chromium levels in children after MIRPE are comparable with adult cohorts with hip arthroplasty implants measured 1-year postoperatively. No acute metal toxicity was observed.

CONCLUSIONS:

Abnormally elevated levels of serum metal levels are measurable in children implanted with pectus bars. These findings warrant further investigation to assess the biocompatibility of this surgical implant in children.

• Authors: Thomas P Cundy, Christopher P Kirby
• Journal: Journal of pediatric surgery (J Pediatr Surg) Vol. 47 Issue 8 Pg. 1506-11 (Aug 2012) ISSN: 1531-5037 [Electronic] United States
• PMID: 22901908 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Biocompatible Materials
• Chromium
• Stainless Steel
• Nickel
• Molybdenum

Topics

• Adolescent
• Biocompatible Materials
• Child
• Chromium (blood, pharmacokinetics)
• Cross-Sectional Studies
• Female
• Funnel Chest (blood, surgery)
• Humans
• Male
• Minimally Invasive Surgical Procedures
• Molybdenum (blood, pharmacokinetics)
• Nickel (blood, pharmacokinetics)
• Pilot Projects
• Postoperative Period
• Prostheses and Implants
• Plastic Surgery Procedures
• Stainless Steel (pharmacokinetics)