Ion levels have been shown to reliably predict abnormal function of the bearing surface with increased wear, but ion levels should not be used alone as a trigger for when to proceed with revision surgery with metal–metal articulations. Risk stratification strategies help determine which patients should be monitored more closely with serial ion levels, cross-sectional imaging with a MARS MRI, or proceed on to revision. Based on the current data available, an ion level greater than 4.5 ppb (Cr or Co) may serve as a threshold for when abnormal wear is occurring, and is suggested as a trigger for a MARS MRI scan.
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The Journal of Arthroplasty, Volume 29, Issue 4, 659 - 660
Hip
Metal Ion Levels: How Can They Help Us?
Griffin, William L.Hip