Distribution of Cobalt Chromium Wear and Corrosion Products and Biologic Reactions

Merritt, Katharine; Brown, Stanley A.

doi:10.1097/00003086-199608001-00020

Cited by 205 publications

(118 citation statements)

References 54 publications

Supporting

Mentioning

106

Contrasting

Unclassified

Order By: Relevance

“…Second, these ions are rapidly transported to the urine and eliminated from the body. Consequently, they are not considered a concern in the biologic response to metal implants [27]. It is well known that a larger diameter femoral head provides better range of motion [7].…”

Section: Discussionmentioning

confidence: 99%

“…Potential effects of chronic increases in serum Co and Cr levels include local tissue toxicity, inflammation, bone loss, renal function alteration, immune modulation, hypersensitivity, chromosomal damage, and malignant cellular transformation [20,27,36,41]. Although there is no evidence prolonged exposure to elevated metal ion release results in any negative biologic effect, the indications for MOM hip resurfacing are limited by concerns related to increased metal ion release [24].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Does Ion Release Differ Between Hip Resurfacing and Metal-on-metal THA?

Moroni

Savarino

Cadossi

et al. 2008

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Modern metal-on-metal hip resurfacing was introduced as a bone-preserving method of joint reconstruction for young and active patients; however, the large diameter of the bearing surfaces is of concern for potential increased metal ion release. We hypothesized there were no differences in serum concentrations of chromium, cobalt, and molybdenum between patients who had metalon-metal hip resurfacing (Group A; average head diameter, 48 mm; median followup, 24 months) and patients who had 28-mm metal-on-metal THA (Group B; median followup, 25 months). Serum concentrations also were compared with concentrations in healthy subjects. We identified no differences in ion levels between Groups A and B. A distinction was made according to gender. Women showed a higher chromium release in Group A whereas men had a higher cobalt release in Group B. Values obtained from Group A were higher than those of the control subjects. Our data suggest metal-on-metal bearings for THA should not be rejected because of concern regarding potential increased metal ion release; however, patients with elevated ion levels, even without loosening or toxicity, could be at higher risk and should be followed up periodically. Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does Ion Release Differ Between Hip Resurfacing and Metal-on-metal THA?

Moroni

Savarino

Cadossi

et al. 2008

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…This mechanism is represented by the transportation system from the local tissues to the blood and by the subsequent elimination through the urine; this clearance mechanism is very effective for Co, Mo and Ni, which are almost completely excreted within 24 -48 hours. 18 As for the Cr, it has been shown that the urinary excretion is not fully effective and that it tends to accumulate in the tissues and in red blood cells. In order to measure the Cr in the red blood cells as well, the present study was performed on whole blood rather than on serum.…”

Section: Discussionmentioning

confidence: 99%

Ion release and chromosomal damage from total hip prostheses with metal‐on‐metal articulation

et al. 2003

View full text Add to dashboard Cite

A prospective multicentric study was carried out in patients having metal-onmetal METASUL components (Sulzer Medica, Winterthur, Switzerland) in order to check the following null hypotheses: H1: The concentration of Co, Cr, Ni, and Mb in blood and urine is not modified by the implant of a hip prosthesis with METASUL components at 6 months. H2: The incidence of markers of chromosomal damage [sister chromatid exchanges (SCEs) and micronuclei (Mni)] in lymphocytes is not modified by the implant of METASUL components at 6 months. H3: The concentrations of Co, Cr, Ni, and Mb in blood and urine did not correlate with the incidence of the markers of chromosomal damage. The measurements showed a 2-fold increase of Co in blood, a 10-fold increase of Co in urine, a 1.5-fold increase of Cr in the blood, and a 3-fold increase of Cr in the urine at a follow-up of 6 months from the operation; there was also a significant increase in the Ni blood concentration at the 7 day checkup. The study cohort did not show any modification in the frequency of markers of chromosomal damage in the peripheral lymphocytes at any of the observation times. The amount of the SCEs and Mni recorded at all the observation times did not correlate with each other or with any of the ion levels measured in the blood and in the urine.

show abstract

“…The expectations for this procedure continue to rise as it is being extended to younger and more active patients whose life expectancy exceeds 30 years postsurgery (Jacobs et al, 1998). These metal prostheses undergo corrosion in the body (Merritt and Brown, 1996;Jacobs, 1999). With the passage of time, this can result in the generation of particulate debris that can accumulate in the tissues adjacent to the prosthesis (Case et al, 1994;Jacobs et al, 1996).…”

mentioning

confidence: 99%

“…The generation of particles from a metal prostheses, which considerably increases the surface area exposed, favours the release of ions that could influence cellular response of the patient to the implant (Merritt and Brown, 1996;Jacobs et al, 1998). This paper investigates the induction of genomic instability and tetraploidy by particulate titanium debris generated from a metal prosthesis.…”

mentioning

confidence: 99%

Particulate debris from a titanium metal prosthesis induces genomic instability in primary human fibroblast cells

Coen¹,

Kadhim

Wright

et al. 2003

Br J Cancer

View full text Add to dashboard Cite

Previous studies detected both lethal and cumulative chromosomal aberrations in bone marrow and peripheral blood of patients with worn hip and knee replacements. This study shows that wear debris from a worn titanium metal on high-density polyethylene hip replacement also produces chromosomal instability and reproductive failure in cell culture. The progeny of these treated cells also displayed chromosomal instability, mainly consisting of chromatid breaks and minutes, and reproductive failure as determined by clonogenic survival many generations postexposure. These delayed effects are similar to those caused by the heavy metals cadmium and nickel and to those seen for low-dose radiation. These findings may have important implications with regard to the long-term risks of joint replacement surgery. This highlights the need for long-term epidemiological studies of patients with surgical implants.

show abstract

Distribution of Cobalt Chromium Wear and Corrosion Products and Biologic Reactions

Cited by 205 publications

References 54 publications

Does Ion Release Differ Between Hip Resurfacing and Metal-on-metal THA?

Does Ion Release Differ Between Hip Resurfacing and Metal-on-metal THA?

Ion release and chromosomal damage from total hip prostheses with metal‐on‐metal articulation

Particulate debris from a titanium metal prosthesis induces genomic instability in primary human fibroblast cells

Contact Info

Product

Resources

About