Exposure to chromium, cobalt and molybdenum from metal-on-metal total hip replacement and hip resurfacing arthroplasty.

Background All metal implants-and metal-on-metal bearings in particular-corrode and cause a release of metal ions. Because cobalt and chromium have been shown to be carcinogenic and mutagenic in human and animal models, systemic toxicity and cancer risk are considered to be possible disadvantages of...

Full description

Bibliographic Details
Published in:Acta Orthopaedica Vol. 77; no. 5; pp. 697 - 706
Main Authors: Witzleb W, Ziegler J, Krummenauer F, Neumeister V, Guenther K
Format: research tables/charts Journal Article
Published: Medical Journals Sweden AB Oct2006
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106179108&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 106179108
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        17453674
        1BVL
      jtl: Acta Orthopaedica
      issn: 17453674
      maglogo: N
    pubinfo:
      dt: Oct2006
      vid: 77
      iid: 5
      pid: 59195
      pub: Medical Journals Sweden AB
    artinfo:
      ui:
        106179108
        106179108
        2009337298
        10.1080/17453670610012863
        NLM17068698
        106179108
      ppf: 697
      ppct: 9
      formats:
        fmt:
          @attributes:
            type: P
      tig:
        atl: Exposure to chromium, cobalt and molybdenum from metal-on-metal total hip replacement and hip resurfacing arthroplasty.
      aug:
        au:
          Witzleb W
          Ziegler J
          Krummenauer F
          Neumeister V
          Guenther K
        affil: Department of Orthopaedic Surgery, Universty Hospital 'Carl Gustav Carus' at the Dresden University of Technology. Dresden. Germany.
      sug:
        subj:
          Arthroplasty Methods
          Arthroplasty, Replacement, Hip
          Chromium Blood
          Cobalt Blood
          Metals Blood
          Prosthesis Design
          Adult
          Body Mass Index Evaluation
          Comparative Studies
          Descriptive Statistics
          Female
          Fisher's Exact Test
          Hip Radiography
          Male
          Middle Age
          Nonparametric Statistics
          Prospective Studies
          Statistical Significance
          Wilcoxon Signed Rank Test
          Human
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background All metal implants-and metal-on-metal bearings in particular-corrode and cause a release of metal ions. Because cobalt and chromium have been shown to be carcinogenic and mutagenic in human and animal models, systemic toxicity and cancer risk are considered to be possible disadvantages of the metal-on-metal articulation. This study was designed to investigate the serum concentration profiles of chromium, cobalt and molybdenum after implantation of a Birmingham hip resurfacing arthroplasty (BHR) and a cementless total hip replacement with a 28-mm Metasul articulation (MTHR), over the first 2 years after implantation. Methods We analyzed profiles of metal ion serum levels in 111 patients implanted with a BHR, in 74 patients implanted with an MTHR, and in 130 implant-free probands control subjects using atomic absorption spectrophotometry. Results Chromium and cobalt concentrations (in mug/L) of all BHR and MTHR patients differed significantly from those of control subjects (chromium: < 0.25; cobalt: 0.25). The median chromium and cobalt concentrations in BHR patients had increased to 5.1 and 4.3 mug/ L 2 years after surgery. Concentrations in BHR patient exceeded those in the unilateral MTHR patients. Molybdenum serum concentrations hardly changed over time in either group and were not significantly different from the concentrations seen in the control subjects. Interpretation During the first 2 years after surgery, the Birmingham hip resurfacing arthroplasty leads to a significantly greater increase in serum chromium and cobalt levels than the 28-mm metal-on-metal MTHR. Observation of patients over a longer period will be necessary in order to evaluate any chronic adverse effects to the system due to elevated chromium and cobalt serum concentrations.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N