Reference Range - MHRA threshold for Patients with MOM implants - 120nmol/L (7ppb).

Ideally blood should be collected using a plastic lined needle as specimen collection via a metal needle may cause significant contamination. If collecting the specimen using a metal needle, then the first 10 mL of blood should be discarded (or utilised for other tests required at the same time e.g. FBC, U and E etc.) only then should the tube for Cobalt analysis be filled.

1. If whole blood chromium or nickel (or both) is also required a single sample may be utilised for all determinations.

2. Blood anti-coagulated with EDTA is our preferred specimen.

   Heparinised blood may also be analysed (utilising the same collection protocol) but it should be noted that heparinised bottles are generally of a larger volume than EDTA bottles.

3. The assay has been developed for use in investigation of excessive wear of M.O.M. joint prostheses.

4. Whole blood is the preferred monitoring medium.

5. Method limitations mean that this assay (as performed at this laboratory) is unsuitable for studies of nutritional status. Normal whole blood cobalt levels (<10nmol/L) would be below the the assay detection limit (20nmol/L).

Additional information on whole blood cobalt and its clinical use can be found here: whole blood cobalt.

Click here for MHRA MDA 2017.

ICE requesting info:	ICE panel name	ICE page name	Column	Comment\Advice
	Chem / Haem	Nutrit & Metab	1

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