Chromium and Cobalt, Metal-on-Metal (MoM) Implants, Whole Blood

Abbrev Code:Labcorp Misc   
Order Code:LAB4909Order Name:Laboratory Miscellaneous Order
Synonyms:MoM Implants; Co; Cr
Methodology:Inductively coupled plasma/mass spectrometry (ICP/MS)
CPT Codes: 82495 x1, 83018 x1
Turnaround Time:Specimens are sent to the reference laboratory Mon-Fri; results are reported in 4-8 days.

Collection Instructions

Optimal Volume:4 mL
Minimum\Peds Volume:0.5 mL
Container:Trace Element, EDTA (DE)

Processing and Shipping

Specimen Processing:Do not process. Store refrigerated.
Shipping Instructions:For storage beyond three days, specimen should be refrigerated or frozen.
Stability:<3 days at room temperature. For storage beyond 3 days, specimen should be refrigerated or frozen.
Test Performed at or Referral Lab Lab Sendouts  (LabCorp)
Referral Lab number:738770


Reference Range:Reference interval is for patients with metal-on-metal (MoM) orthopedic implants. An algorithm intended as an aid for orthopedic surgeons in the assessment and management of patients with metal-on-metal bearings was published in 2014. [J Bone Joint Surg Am. 2014 Jan 1; 96(1):e4. PubMed 24382732]

The systematic risk stratification includes recommendations for multiple modes of failure and stratifies patient risk groups based on a thorough clinical history, a detailed physical examination, radiographic tests, and laboratory tests, including measurement of metal ions (chromium and cobalt).

The following stratification applies to chromium or cobalt as individual analytes, not to the combined total.
  • Low risk group: <3.0 ng/mL
  • Moderate risk group: 3.0−10.0 ng/mL
  • High risk group: >10.0 ng/mL
Metal ion tests are an important adjunct to systemic clinical assessment; however, metal ion levels alone should not be relied on as the sole parameter to determine clinical recommendations for revision surgery.
Use:Detect metal ion accumulation caused by metal-on-metal (MoM) implants.

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