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...
| Published in: | Acta Orthopaedica Vol. 77; no. 5; pp. 697 - 706 |
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| Main Authors: | , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Medical Journals Sweden AB
Oct2006
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| 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 |
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