Quality, but not quantity of physical activity is associated with metal ion concentrations in unilateral hip resurfacing

Jetse Jelsma*, Martijn G.M. Schotanus, Sander M.J. van Kuijk, Ivo T.A.F. Buil, Ide C. Heyligers, Bernd Grimm

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)


Little is known about the influence of physical activity (PA) on metal ion concentrations in subjects with metal-on-metal hip arthroplasty. Implant wear is thought to be a function of use and thus of patient activity levels. It is hypothesized that daily habitual PA of patients with hip resurfacing arthroplasty (HRA) is associated with metal ion concentrations. Therefore a study was conducted in patients with a unilateral HRA at 10-years follow-up. Blood metal ion concentrations were determined. An acceleration-based activity monitor was used to measure PA in daily life. The cohort consisted of 12 males (75%) and 4 females (25%) with a median age at surgery of 55.5 ± 9.7 years [43.0–67.9] and a median follow-up of 9.9 ± 1.0 years [9.1–10.9]. The median cobalt and chromium ion concentrations were 25 ± 13 and 38 ± 28 nmol/L. A significant association between sit-stand transfers and high-intensity peaks with cobalt ion concentrations were found. Regarding PA and metal ion concentrations as a proxy of wear in HRA, specific activities like transfers or qualitative aspects of activity behavior like intensity, seem to matter more than the quantity of low-intensity activities like walking or cycling. This suggests that patients may safely engage in such activities to achieve important general health benefits and quality of life.

Original languageEnglish
Pages (from-to)2206-2212
Number of pages7
JournalJournal of Orthopaedic Research
Issue number10
Publication statusPublished - 1 Oct 2020


  • activity monitoring
  • hip resurfacing arthroplasty
  • metal ion concentrations
  • physical activity
  • wearable sensor technology


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