Systemic Disease After Hip Replacement: Aeromedical Implications of Arthroprosthetic Cobaltism

Sotos, John G.; Tower, Stephen S.

doi:10.3357/asem.3262.2013

Cited by 21 publications

(18 citation statements)

References 8 publications

(8 reference statements)

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“…Systemic cobaltism following MoM THA has been published in previous case reports and series [12] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] . A systematic review of 25 patients identified several organ systems involved with the cardiovascular system (60%) being the most frequently affected, followed by central nervous system.…”

Section: Discussionmentioning

confidence: 99%

Arthroprosthetic cobaltism associated with cardiomyopathy

2017

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Systemic cobaltism related to metal-on-metal total hip arthroplasty has been published in case reports and series with effects on the cardiac, neurologic, endocrine, and immunologic systems. This case report presents a 46-year-old male who underwent bilateral metal-on-metal total hip arthroplasty and subsequently developed cardiomyopathy requiring left ventricular assist device implantation. Intervention with bilateral revision to non-cobalt-containing implants resulted in improved cardiac function. This case report will alert clinicians to the presentation of this rare but devastating complication while also displaying improvement following revision total hip arthroplasty. It is our hope this case will aid in early recognition and intervention of this condition.

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Section: Discussionmentioning

confidence: 99%

Arthroprosthetic cobaltism associated with cardiomyopathy

2017

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“…CoNPs produced by the reduction or wear of internal plants are rst deposited around the internal xation plate and arti cial joint prosthesis to cause in ammatory pseudotumor around the implant, loosening of the prosthesis, as well as local osteoporosis. Meanwhile, due to their nano-size effect, CoNPs are more likely to enter into the blood and lymphatic system, followed by their broad distribution in multiple organs or tissues of the human body through systemic circulation, resulting in different adverse symptoms [4][5][6][8][9][10][11]. Therefore, the patients undergoing MOM joint replacement need to be monitored and detoxi ed.…”

Section: Introductionmentioning

confidence: 99%

Alpha Lipoic Acid Antagonizes Cytotoxicity of Cobalt Nanoparticles by Inhibiting Ferroptosis-like Cell Death

Liu

Zhu

et al. 2020

Preprint

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As a main element in the hard metal industry, cobalt is one of the major components of human metal implants. Cobalt-containing implants, especially joint prostheses used for artificial joint replacement, can be corroded due to the complex physiological environment in vivo, producing a large number of nanoscale cobalt particles (Cobalt Nanoparticles, CoNPs). These CoNPs can be first accumulated around the implant to cause adverse local reactions and then enter into the blood vessels followed by reaching to the liver, heart, brain, kidney, and other organs through systematic circulation, which leads to multi-system toxicity symptoms. To ensure the long-term existence of cobalt-containing implants in the body, it is urgently required to find out a safe and effective detoxification drug. Herein, we have demonstrated that CoNPs could induce the ferroptosis-like cell death through the enhancement of intracellular reactive oxygen species (ROS) level, cytoplasmic Fe2+ level, lipid peroxidation and consumption of reduced glutathione (GSH) as well as inhibition of glutathione peroxidase 4 (GPX4) activity. Importantly, α-lipoic acid (ALA), a natural antioxidant with the capability to scavenge free radicals and chelate toxic metals, was found to efficiently alleviate the adverse effects of CoNPs. The present study illustrates a new mechanism of CoNPs mediated by ferroptosis-like cytotoxicity and discloses an effective method for the detoxification of CoNPs by employing the natural antioxidant of ALA, providing a basis for further in vivo detoxification study.

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“…Among these particles, cobalt nanoparticles (CoNPs) are the most abundant ones with the highest toxicity [1,2], which could cause early failure of arti cial joints [3]. Tower et al well demonstrated the multiple systemic adverse reactions after metal-on-metal (MOM) joint replacement and named the disease as arthroprosthetic cobaltism syndrome (ACS) [4][5][6][7][8]. CoNPs produced by the reduction or wear of internal plants are rst deposited around the internal xation plate and arti cial joint prosthesis to cause in ammatory pseudotumor around the implant, loosening of the prosthesis, as well as local osteoporosis.…”

Section: Introductionmentioning

confidence: 99%

Alpha lipoic acid antagonizes cytotoxicity of cobalt nanoparticles by inhibiting ferroptosis-like cell death

Liu

Zhu

et al. 2020

Preprint

View full text Add to dashboard Cite

As a main element in the hard metal industry, cobalt is one of the major components of human metal implants. Cobalt-containing implants, especially joint prostheses used for artificial joint replacement, can be corroded due to the complex physiological environment in vivo , producing a large number of nanoscale cobalt particles (Cobalt Nanoparticles, CoNPs). These CoNPs can be first accumulated around the implant to cause adverse local reactions and then enter into the blood vessels followed by reaching to the liver, heart, brain, kidney, and other organs through systematic circulation, which leads to multi-system toxicity symptoms. To ensure the long-term existence of cobalt-containing implants in the body, it is urgently required to find out a safe and effective detoxification drug. Herein, we have demonstrated that CoNPs could induce the ferroptosis-like cell death through the enhancement of intracellular reactive oxygen species (ROS) level, cytoplasmic Fe 2+ level, lipid peroxidation and consumption of reduced glutathione (GSH) as well as inhibition of glutathione peroxidase 4 (GPX4) activity. Importantly, α-lipoic acid (ALA), a natural antioxidant with the capability to scavenge free radicals and chelate toxic metals, was found to efficiently alleviate the adverse effects of CoNPs. The present study illustrates a new mechanism of CoNPs mediated by ferroptosis-like cytotoxicity and discloses an effective method for the detoxification of CoNPs by employing the natural antioxidant of ALA, providing a basis for further in vivo detoxification study.

show abstract

Systemic Disease After Hip Replacement: Aeromedical Implications of Arthroprosthetic Cobaltism

Cited by 21 publications

References 8 publications

Arthroprosthetic cobaltism associated with cardiomyopathy

Arthroprosthetic cobaltism associated with cardiomyopathy

Alpha Lipoic Acid Antagonizes Cytotoxicity of Cobalt Nanoparticles by Inhibiting Ferroptosis-like Cell Death

Alpha lipoic acid antagonizes cytotoxicity of cobalt nanoparticles by inhibiting ferroptosis-like cell death

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