Blood metal levels, leucocyte profiles, and cytokine profiles in patients with a modular dual-mobility hip prosthesis

Aims The aim of this study was to evaluate blood metal ion levels, leucocyte profiles, and serum cytokines in patients with a total hip arthroplasty (THA) involving modular dual-mobility components. Patients and Methods A total of 39 patients were recruited, with clinical follow-up of up to two years. Outcome was assessed using the Harris Hip Score (HHS, the 12-Item Short-Form Health Survey (SF-12), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and a visual analogue scale (VAS) for pain. Blood concentrations of cobalt (Co), chromium (Cr), and serum cytokines were measured. Subpopulations of leucocytes were analyzed by flow cytometry. Results The clinical performance was good. Blood Co levels (ref 1.0 µg/l) were mildly elevated in seven patients at three months, and two patients at two years’ follow-up. The preoperative Cr levels were normal except for one patient with a detectable Cr (1.2 µg/l). Cr levels were detectable in three patients at three months, two patients at one year, and three patients at two years’ follow-up. No patients had symptoms suggestive of failure. Although flow cytometry showed constant circulating leucocyte profiles, there was a significant reduction of serum interleukin (IL)-4, IL-5, and interferon gamma (IFNγ) postoperatively compared with the preoperative levels (p < 0.05). Conclusion These results suggest that THA using modular dual-mobility components is safe. This allows an opportunity to use a large femoral head and a thick polyethylene bearing surface, which is especially useful in revision procedures or high-risk situations when added stability is required. Cite this article: Bone Joint J 2019;101-B:1035–1041.

Leucocyte Profiles and Family Size in Fledgling Greylag Geese (Anser Anser)

In precocial species, large brood sizes are usually considered as beneficial and individuals in larger broods grow faster and are more dominant compared to individuals in small broods. However, little is known whether family size also beneficially affects the offspring's physiology. In the present study, we investigated whether leucocyte profiles in fledgling Greylag Geese ( Anser anser) are affected by (1) family size, (2) individual characteristics, i.e. age, body condition or sex, or (3) characteristics of the parents, i.e. previous reproductive success. From spring 2013 to autumn 2015, we collected blood samples from 100 juvenile Greylag Geese from 20 different pairs. From these samples we determined the absolute leucocyte number, an individual's differential blood cells count and an individual's haematocrit (HCT). The number of fledglings in a family and therefore the number of siblings a focal individual had, was positively related to the percentage of basophils, negatively to the heterophils/lymphocytes ratio (H/L), and tended to be negatively related to the percentage of monocytes and eosinophils in a sample. H/L ratio was negatively related to age in days and tended to be negatively related to body condition, whereas the percentage of basophils tended to be positively related to it. Absolute leucocyte number did not differ between individuals depending on family size. However, composition of different leucocyte types (basophils, eosinophils, H/L ratio) was modulated mostly by the social environment (family size) and not by the characteristics of the individual or the parents. In conclusion, even though we did not find clear evidence of a positive health effect, i.e. a better immune system, in fledgling Greylag Geese of large versus small families, our results suggest that family size modulates different components of the immune system hinting at its stress-reducing effect.