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ACB-CLIN-CHEM-GEN  May 2010

ACB-CLIN-CHEM-GEN May 2010

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Subject:

Re: Cobalt and Chromium in hip replacements

From:

EDWARD KEARNEY <[log in to unmask]>

Reply-To:

EDWARD KEARNEY <[log in to unmask]>

Date:

Thu, 13 May 2010 10:33:30 +0100

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (174 lines)

Dear All,
I think the units is a minor issue. How can we get samples without contamination?
Regards,
Edward

>>> "Sampson, Barry" <[log in to unmask]> 12/05/2010 22:42 >>>
Dear Michael and all
I think I can say that we are all going to keep reporting in molar units.  I will put a comment on reports, and surgeons will just have to live with that.
Barry

-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Colley, Michael
Sent: 11 May 2010 16:51
To: [log in to unmask] 
Subject: Re: Cobalt and Chromium in hip replacements

A major problem here is that the MHRA specify concentration in parts per billion but do not state whether this is a UK billion (10^12) or a US billion (10^9).
Why can't they use nmol/L then there would be no confusion.
Anyone have any further info and a guaranteed conversion factor?
Michael
Dr C M Colley
Consultant Chemical Pathologist
Great Western Hospital
Swindon  SN3 6BB

From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Verrill Helen (RVW) Pathology
Sent: 07 May 2010 17:48
To: [log in to unmask] 
Subject: Re: Cobalt and Chromium in hip replacements

Sally

I've been involved with a group set up to deal with this problem. The approach in this Trust is that measurement of cobalt and chromium in blood must be done in conjunction with a clinical assessment (Harris hip score I think). We're stratifying patients according to hip score, blood analysis and imaging of the affected joint. The orthopaedic directorate here have undertaken to cover our referral costs.

The MHRA alert gives a deadline of 17th June for providers of hip replacement services to have a system in place to follow up patients, there is no mention (or probably expectation) that GP's will be involved in the actual follow up. The one good thing is that the MHRA have clearly taken on board the need for quality, reliable results by their requirement that any lab providing such an analysis is part of the TEQAS scheme,

helen

Helen Verrill
Consultant Clinical Scientist
North Tees and Hartlepool NHS Foundation Trust

01642 624455

Please consider resources and print this e-mail only if essential
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Benton Sally
Sent: 06 May 2010 16:30
To: [log in to unmask] 
Subject: Re: Cobalt and Chromium in hip replacements
Dear Jessica,
I was going to post a similar question.  I had a phone call earlier from one of our GP's about the same MHRA alert.  He was wondering whether this is a "screening test" they can do in the GP practices to avoid having to refer patients to orthopaedics and hence, basically, save the cost of the referral (at least that was my understanding of his question).
I would also be interested to hear any opinions or recommendations as to what we should do with such queries.
Thanks

Sally



Sally C Benton
Consultant Biochemist
Barts and the London NHS Trust
Department Clinical Biochemistry
Pathology and Pharmacy Building
Royal London Hospital
E1 2ES

Tel: 0203 2460386
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Jessica Schroeder
Sent: 06 May 2010 16:22
To: [log in to unmask] 
Subject: Cobalt and Chromium in hip replacements

Following the MHRA Medical Device Alert on all metal-on-metal hip replacements, we have been contacted by one of our Orthopaedic consultants enquiring about measuring blood cobalt and chromium levels.

I would be interested to know:
Are other labs taking on this service? Has it been funded?
What labs can do the analysis and what are the sample requirements /costs?

Regards

Jessica Schroeder

Jessica Schroeder
Principal Biochemist
Royal Cornwall Hospital
Truro


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