AzTrials
AzTrials

Serum Metal Levels, Specifically Cobalt, Chromium, and TitaniumPhase 4NCT03371212

A Prospective Randomized Controlled Trial of Dual-Mobility Components in Primary THA

A Phase 4 study testing Dual mobility cohort and Conventional cohort in people with Serum Metal Levels, Specifically Cobalt, Chromium, and Titanium, run by Rush University Medical Center at 1 site in United States.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
Search all trials

Trial summary

The aim of this study is to determine if the use of a modular dual mobility bearing is associated with clinically important increases in serum metal levels. Read more about this study

Who is it for?
Ages 18 to 80 years
What is being tested?
Dual mobility cohort and Conventional cohort
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
52 participants
Where
1 siteUnited States
Study dates
15 Dec 2017to 1 Dec 2036
Phase
Phase 4
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age between 18 and 80 years
  • Willingness to undergo serial postoperative venipuncture for serum meal analysis
  • BMI < 40
  • Patients that are eligible for the requisite implants as deemed by their surgeon

Who cannot join

  • Clinically significant systemic chronic disease
  • Diminished renal function
  • Presence of any metal-containing implant outside of the oral cavity
  • History of prior hip surgery involving an internal fixation device
  • History of hip infection
  • Preoperative diagnosis other than osteoarthritis
  • Anticipated need for another joint replacement surgery within one year
  • Patients taking chromium supplements

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Rush University Medical Center

    Chicago, Illinois, 60612

Other trials in United States

About this study

Official title: A Prospective Randomized Trial of Modular Dual Mobility Acetabular Components Versus Conventional Single Bearing Components in Primary Total Hip Arthroplasty

The aim of this study is to determine if the use of a modular dual mobility bearing is associated with clinically important increases in serum metal levels.

Read the detailed description

Prosthetic dislocation following total hip arthroplasty (THA) remains a significant concern with a reported incidence of 0.2%-7.0% after primary and 10%-25% after revision THA. The risk of dislocation following THA is multifactorial and includes both surgeon-related factors (i.e. component positioning, surgical approach) and patient-related factors (i.e. gender, age). Dual mobility articulations have been shown to reduce the incidence of hip instability following THA. Dual mobility implants have been used in Europe for over 30 years, but have recently received an increased interest in the United States.

Initial dual mobility designs consisted of a cementless, monoblock acetabular component with a highly-polished metal inner bearing surface. Modular dual mobility prostheses have been introduced in which a modular cobalt-alloy liner is inserted into a hemispherical titanium acetabular component. Advantages of this construct include familiarity of use of a standard titanium acetabular component and the ability to use supplemental screw fixation. However, the potential for fretting corrosion between the cobalt-alloy liner and the titanium acetabular component remains a concern.

In a retrospective review of 100 consecutive patients undergoing primary THA using a modular dual mobility prosthesis, the authors found 21% of patients to have a serum cobalt level above the normal range, with 9% significantly above normal (> 1.6 ug/L), at a mean of 27.6 months postoperatively. In addition, a recent prospective cohort study of 26 patients receiving the same prosthesis showed elevated whole blood mean cobalt levels in patients receiving a modular dual mobility prosthesis versus patients receiving a conventional bearing (0.23 + 0.39 vs. 0.15 + 0.07ug/L, p<0.001) at 1 year postoperatively. Four patients in the dual mobility cohort had a whole blood cobalt level outside the reference range (maximum 1.81 ug/L).

To the investigators knowledge no prospective, randomized controlled trial has been performed comparing dual mobility bearings to a conventional single-bearing design. Therefore, the purpose of this study is to compare the use of a conventional single-bearing ceramic-on-polyethylene surface to use of a modular dual mobility bearing in a prospective, randomized controlled setting.

Being tested
Dual mobility cohort, Conventional cohort
Keywords
Dual Mobility, Serum metal levels

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Dual mobility cohortDevice

    Patients will receive the Taperloc femoral stem, ceramic femoral head (size 32mm for acetabular components 48/50mm; size 36mm for acetabular components > 52mm), polyethylene bearing, and G7 acetabular shell.

  • Conventional cohortDevice

    Patients will receive a Taperloc femoral stem, ceramic femoral head (size 32mm for acetabular components 48/50mm; size 36mm for acetabular components > 52mm), polyethylene bearing, and G7 acetabular shell

Study groups in NCT03371212
Study groupRoleWhat they receive
Conventional CohortActive comparatorPatients in this group will receive a Taperloc femoral stem, ceramic femoral head (size 32mm for acetabular components 48/50mm; size 36mm for acetabular components > 52mm), polyethylene bearing, and G7 acetabular shell.
Receives: Device: Conventional cohort
Modular Dual Mobility CohortExperimentalPatients in this group will receive a Taperloc femoral stem, inner ceramic femoral head (28mm), mobile polyethylene bearing, cobalt alloy liner, and G7 acetabular shell.
Receives: Device: Dual mobility cohort

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Serum chromium levels, measures chromium level in the serum in ug/L

    Assays for each subject for serum chromium in ug/L

    Measured: up to 5 years

  2. Serum cobalt levels, measures cobalt level in the serum in ug/L

    Assays for each subject for serum cobalt in ug/L

    Measured: up to 5 years

  3. Serum titanium levels, measures titanium level in the serum in ug/L

    Assays for each subject for serum titanium in ug/L

    Measured: up to 5 years

Secondary outcomes (5)
  1. Patient reported outcome measures (survey) for SF-12 score.

    Subjects will complete the industry common SF-12 survey and total score will be used. Higher scores are better, score of 100 is maximum.

    Measured: up to 5 years

  2. Patient reported outcome measures (survey) for the Harris Hip Score

    Subjects will complete the industry common Harris Hip survey and total score will be used. Higher scores are better, score of 100 is maximum.

    Measured: up to 5 years

  3. Patient reported outcome measures (survey) for the Hoos Jr. score.

    Subjects will complete the industry common HOOS Jr. survey and total score will be used. Higher scores are better, score of 100 is maximum.

    Measured: up to 5 years

  4. Patient reported outcome measures (survey) for the SANE score.

    Subjects will complete the the industry common SANE survey and total score will be used. Higher scores are better, score of 100 is maximum.

    Measured: up to 5 years

  5. Patient reported outcome measures (survey) for the UCLA activity score.

    Subjects will complete the the industry common UCLA survey and total score will be used. Higher scores are better, score of 100 is maximum.

    Measured: up to 5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Dec 2017
  2. Study start15 Dec 2017
  3. Primary completion1 Dec 2035 (estimated)
  4. Study completion1 Dec 2036 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Patients will be randomized to 1 of 2 treatment groups, which they will be in for the duration of the study. Because of the nature of the study, there will be no crossover.
Masking
Single blind
Who is masked
Participant
Enrolment
52 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03371212
Sponsor's protocol ID
17060804
Status last verified
Jan 2026
First submitted
4 Dec 2017
Last updated
8 Jan 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Publications

  • Patel PD, Potts A, Froimson MI. The dislocating hip arthroplasty: prevention and treatment. J Arthroplasty. 2007 Jun;22(4 Suppl 1):86-90. doi: 10.1016/j.arth.2006.12.111.

    PubMed 17570285
  • Berry DJ. Unstable total hip arthroplasty: detailed overview. Instr Course Lect. 2001;50:265-74.

    PubMed 11372323
  • Nam D, Salih R, Brown KM, Nunley RM, Barrack RL. Metal Ion Levels in Young, Active Patients Receiving a Modular, Dual Mobility Total Hip Arthroplasty. J Arthroplasty. 2017 May;32(5):1581-1585. doi: 10.1016/j.arth.2016.12.012. Epub 2016 Dec 21.

    PubMed 28057394
  • Haughom BD, Plummer DR, Moric M, Della Valle CJ. Is There a Benefit to Head Size Greater Than 36 mm in Total Hip Arthroplasty? J Arthroplasty. 2016 Jan;31(1):152-5. doi: 10.1016/j.arth.2015.08.011. Epub 2015 Aug 14.

    PubMed 26360768
  • Matsen Ko LJ, Pollag KE, Yoo JY, Sharkey PF. Serum Metal Ion Levels Following Total Hip Arthroplasty With Modular Dual Mobility Components. J Arthroplasty. 2016 Jan;31(1):186-9. doi: 10.1016/j.arth.2015.07.035. Epub 2015 Jul 23.

    PubMed 26318084
  • Heffernan C, Banerjee S, Nevelos J, Macintyre J, Issa K, Markel DC, Mont MA. Does dual-mobility cup geometry affect posterior horizontal dislocation distance? Clin Orthop Relat Res. 2014 May;472(5):1535-44. doi: 10.1007/s11999-014-3469-1. Epub 2014 Jan 24.

    PubMed 24464508
  • Langlais FL, Ropars M, Gaucher F, Musset T, Chaix O. Dual mobility cemented cups have low dislocation rates in THA revisions. Clin Orthop Relat Res. 2008 Feb;466(2):389-95. doi: 10.1007/s11999-007-0047-9. Epub 2008 Jan 10.

    PubMed 18196422
  • Loving L, Lee RK, Herrera L, Essner AP, Nevelos JE. Wear performance evaluation of a contemporary dual mobility hip bearing using multiple hip simulator testing conditions. J Arthroplasty. 2013 Jun;28(6):1041-6. doi: 10.1016/j.arth.2012.09.011. Epub 2013 Feb 22.

    PubMed 23434106
  • Civinini R, Carulli C, Matassi F, Nistri L, Innocenti M. A dual-mobility cup reduces risk of dislocation in isolated acetabular revisions. Clin Orthop Relat Res. 2012 Dec;470(12):3542-8. doi: 10.1007/s11999-012-2428-y. Epub 2012 Jun 15.

    PubMed 22700131
  • Hamadouche M, Arnould H, Bouxin B. Is a cementless dual mobility socket in primary THA a reasonable option? Clin Orthop Relat Res. 2012 Nov;470(11):3048-53. doi: 10.1007/s11999-012-2395-3.

    PubMed 22639330
  • Epinette JA, Beracassat R, Tracol P, Pagazani G, Vandenbussche E. Are modern dual mobility cups a valuable option in reducing instability after primary hip arthroplasty, even in younger patients? J Arthroplasty. 2014 Jun;29(6):1323-8. doi: 10.1016/j.arth.2013.12.011. Epub 2013 Dec 16.

    PubMed 24444567
  • Plummer DR, Christy JM, Sporer SM, Paprosky WG, Della Valle CJ. Dual-Mobility Articulations for Patients at High Risk for Dislocation. J Arthroplasty. 2016 Sep;31(9 Suppl):131-5. doi: 10.1016/j.arth.2016.03.021. Epub 2016 Mar 17.

    PubMed 27101771
  • McArthur BA, Nam D, Cross MB, Westrich GH, Sculco TP. Dual-mobility acetabular components in total hip arthroplasty. Am J Orthop (Belle Mead NJ). 2013 Oct;42(10):473-8.

    PubMed 24278908
  • Farizon F, de Lavison R, Azoulai JJ, Bousquet G. Results with a cementless alumina-coated cup with dual mobility. A twelve-year follow-up study. Int Orthop. 1998;22(4):219-24. doi: 10.1007/s002640050246.

    PubMed 9795807

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Dual mobility cohort and Conventional cohort in people with Serum Metal Levels, Specifically Cobalt, Chromium, and Titanium, run by Rush University Medical Center at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 8 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Serum chromium levels, measures chromium level in the serum in ug/L (time frame: up to 5 years). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03371212, which also lists 14 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Jan 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in