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Test Code TIS Titanium, Serum

Important Note

  • Must be drawn at Outpatient Lab at the Main Campus
  • Collect in Royal Blue Tube with RED label

Reporting Name

Titanium, S

Useful For

Monitoring metallic prosthetic implant wear

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum


Specimen Required


Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metal tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for at least 96 hours.

Supplies:

-Metal Free Specimen Vial (T173)

-Metal Free B-D Tube (No Additive), 6 mL (T184)

Collection Container/Tube: Plain, royal blue-top Vacutainer plastic trace element blood collection tube

Submission Container/Tube: 7-mL Metal-free, screw-capped, polypropylene vial

Specimen Volume: 1.2 mL

Collection Instructions:

1. Allow specimen to clot for 30 minutes; then centrifuge the specimen to separate serum from the cellular fraction.

2. Remove the stopper. Carefully pour specimen into a metal-free, polypropylene vial, avoiding transfer of the cellular components of blood. Do not insert a pipet into the serum to accomplish transfer, and do not ream the specimen with a wooden stick to assist with serum transfer.

3. See Metals Analysis Specimen Collection and Transport for complete instructions.


Specimen Minimum Volume

0.4 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 28 days METAL FREE
  Frozen  28 days METAL FREE
  Ambient  7 days METAL FREE

Reference Values

<2 ng/mL

Day(s) Performed

Wednesday

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

83018

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TIS Titanium, S 8244-6

 

Result ID Test Result Name Result LOINC Value
89367 Titanium, S 8244-6

Interpretation

Prosthesis wear is known to result in increased circulating concentration of metal ions. In the absence of an implant, circulating titanium is below 1 ng/mL. Modest increase (1.0-3.0 ng/mL) in serum titanium concentration is evident with a prosthetic device in good condition. Serum concentrations above 10 ng/mL in a patient with titanium-based implant suggest prosthesis wear.

 

Increased serum titanium concentration in the absence of corroborating clinical information does not independently predict prosthesis wear or failure.

Clinical Reference

1. Rifai N, Horvath AR, Wittwer, CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics 6th ed. Elsevier; 2018

2. Chao EY, Frassica F, Prichard DJ, Moyer TP: Metal ion release in patients with porous coated megaprostheses. 41st Annual Meeting of the Orthopaedic Research Society, Orlando, Florida, 1995 Feb 13-16

3. Jacobs JJ, Skipor AK, Patterson LM, et al. Metal release in patients who have had a primary total hip arthroplasty. A prospective, controlled, longitudinal study. J Bone Joint Surg Am. 1998;80(10):1447-1458

4. Liu TK, Liu SH, Chang CH, Yang RS. Concentration of metal elements in the blood and urine in the patients with cementless total knee arthroplasty. Tohoku J Exp Med. 1998;185:253-262

5. Krachler M, Domj W, Irgolic KJ. Concentrations of trace elements in osteoarthritic knee-joint effusions. Biol Trace Elem Res. 2000;75:253-263

Report Available

2 to 8 days

Method Name

Triple-Quadrupole Inductively Coupled Plasma Mass Spectrometry (ICP-MS)