Systemic effects of implanted prostheses made of cobalt-chromium alloys

  title={Systemic effects of implanted prostheses made of cobalt-chromium alloys},
  author={Rolf Michel and M. Nolte and Michael Reich and F. L{\"o}er3},
  journal={Archives of Orthopaedic and Trauma Surgery},
SummarySystemic effects of Co-Cr alloy/polyethylene hip joint prostheses were investigated using instrumental neutron activation to determine the concentrations of up to 16 elements. First, in a prospective study whole blood and serum taken from 10 patients from 1 day before to 90 days after implantation were analyzed. Secondly, in a retrospective study whole blood and serum from 23 patients who had had prostheses in place for up to 18 years were analyzed. For comparison, normal trace element… 
Synchrotron analysis of human organ tissue exposed to implant material.
Chromium speciation in the blood of metal-on-metal hip implant patients
The analysis showed that Cr released from hip implants preferentially distributed into serum and not RBC, indicating that the form of Cr present in blood of hip implant patients was in the forms of non-toxic Cr(III).
Serum cobalt levels after metal-on-metal total hip arthroplasty.
Systemic cobalt release from Metasul metal-on-metal articulations was demonstrated throughout the five-year study period and the median serum cobalt concentrations were found to be slightly above the detection limit and remained in a constant range.
Differences in metal ion release following cobalt-chromium and oxidized zirconium total knee arthroplasty.
There does not appear to be any significant rise in serum metal ion levels following total knee arthroplasty several years after implantation, and no statistically significant differences were found between the groups.
Changes of concentrations of the elements Co, Cr, Sb, and Sc in tissues of persons with joint implants
Elevated levels of Co and Cr were found in several organs of deceased implant bearers (CoCr-alloy/polyethylene joint prostheses) by means of instrumental and radiochemical neutron activation analysis
Effect of biomaterial on integrity and life of artificial hip
Hip replacement is a surgical procedure in which parts of the hip joint are removed and replaced with artificial parts, which is known as the prosthesis. Metallic alloys are used for prosthesis, its
Cobalt, chromium and molybdenum ions kinetics in the human body: data gained from a total hip replacement with massive third body wear of the head and neuropathy by cobalt intoxication
Early diagnosis of high metal wear can be ascertained with mass spectrometry and after revision high levels of metal ions can only be reduced with repeated chelating treatment.
Elevated serum cobalt with metal-on-metal articulating surfaces.
The findings indicate that metal-on-metal bearings generate some systemic release of cobalt, which is consistent with iatrogenic cobalt loading.
Interpreting cobalt blood concentrations in hip implant patients
These studies indicate that significant systemic effects of cobalt will not occur below blood cobalt concentrations of 300 μg/L in most persons, and patients with metal-containing hip implants who exhibit signs or symptoms potentially related to polycythemia, hypothyroidism, neurological, or cardiac dysfunction should be clinically evaluated for these conditions.


Trace element burdening of human tissues due to the corrosion of hip-joint prostheses made of cobalt-chromium alloys
A comparison of the tissue analyses with the corrosion experiments demonstrates that the distribution patterns of the corrosion products in the tissues are influenced by both the corrosion process and the biochemical properties of the corroding products.
Neutron activation analysis of human tissues, organs and body fluids to describe the interaction of orthopaedic implants made of cobalt-chromium alloy with the patients organisms
The results demonstrate that there are high enrichments of corrosion products in several tissues and organs and that also blood and serum reveal the presence of the metal implants in the trace element levels, increasing shortly after implantation and pertaining during the entire implantation time.
[Tissue burden with exogenous trace elements caused by roentgen contrast media in bone cements].
In 44 patients undergoing a change of total hip prosthesis, made of Co-Cr alloy and at one point with a Refobacin-Palacos chain we analyzed samples of the hip joint capsule and fascia lata. Using
Metal ion release after total hip replacement.
Corrosion behaviour of stainless steel implants in biological media
The corrosion behaviour of orthopaedic metal implants was studied in an animal experiment in which 30 rabbits had stainless steel plates implanted after a varization osteotomy of the tibiae of their
Cobalt toxicity after McKee hip arthroplasty.
Seven patients are described in whom McKee hip arthroplasties became unsatisfactory after periods varying from nine months to four years, and six of these patients were cobalt-positive but nickel- and chrome-negative on patch testing.
Trace elements in human body fluids and tissues.
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Critically selected reference values are set forth for trace element levels in human blood plasma or serum, packed blood cells, urine, lung, liver, kidney, and skeletal muscle tissue in an effort to settle the currently flourishing confusion.
Metal Carcinogenesis
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Experimental and epidemiologic evidence in recent years has clearly shown that metal speciation is an urgent problem for risk estimation in metal carcinogenesis and the most important recent progress has been published for nickel and ~hromium.