BACKGROUND Hip implants are usually manufactured from cobalt-chromium and titanium alloys. As the implants wear and corrode, metal debris is released into the surrounding tissue and blood, providing a potential biomarker for their function. Whilst there are laboratory reference levels for blood cobalt and chromium in patients with well and poorly functioning hip implants, there are no such guidelines for titanium. This is despite the increasing use of titanium implants worldwide. PATIENTS AND METHODS We recruited a consecutive series of 95 patients (mean age 71 years, mean time after surgery 8.5 years) with one hip implant type, inserted by the same surgeon. We assessed clinical and radiological outcome, and measured blood and plasma titanium using high resolution inductively-coupled plasma mass spectrometry. RESULTS The upper normal reference limit for blood and plasma titanium was 2.20 and 2.56 μg L-1, respectively, and did not differ significantly between males and females. CONCLUSION We are the first to propose a laboratory reference level for blood and plasma titanium in patients with well-functioning titanium hip implants. This is an essential starting point for further studies to explore the clinical usefulness of blood titanium as a biomarker of orthopaedic implant performance, and comes at a time of considerable controversy regarding the use of certain titanium alloys in hip arthroplasty.

中文翻译：

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血液和血浆钛水平与功能良好的髋关节植入物有关。

背景技术髋关节植入物通常由钴铬和钛合金制成。随着植入物的磨损和腐蚀，金属碎片会释放到周围的组织和血液中，为其功能提供潜在的生物标记。对于髋关节植入物功能良好和功能较差的患者，虽然有血钴和铬的实验室参考水平，但没有针对钛的此类指导原则。尽管在全球范围内越来越多地使用钛植入物。患者和方法我们连续招募了95例患者（平均年龄71岁，平均术后时间8.5年），并由同一位外科医生植入了一种髋关节植入物。我们评估了临床和放射学结果，并使用高分辨率感应耦合等离子体质谱仪测量了血液和血浆中的钛。结果血液和血浆钛的正常正常上限分别为2.20和2.56μgL-1，男女之间无显着差异。结论我们是第一个提出功能正常的钛髋关节植入物患者的血液和血浆钛的实验室参考水平的人。这是进一步研究以探索血液钛作为骨科植入物性能的生物标志物的临床实用性的重要起点，并且在某些钛合金在髋关节置换术中的使用方面存在争议。结论我们是第一个提出功能正常的钛髋关节植入物患者的血液和血浆钛的实验室参考水平的人。这是进一步研究以探索血液钛作为骨科植入物性能的生物标志物的临床实用性的重要起点，并且在某些钛合金在髋关节置换术中的使用方面存在争议。结论我们是第一个提出功能正常的钛髋关节植入物患者的血液和血浆钛的实验室参考水平的人。这是进一步研究以探索血液钛作为骨科植入物性能的生物标志物的临床实用性的重要起点，并且在某些钛合金在髋关节置换术中的使用方面存在争议。