title: Widespread dissemination of metal debris from implants.
abstract: In a post-mortem study, we compared subjects with metal implants with and without visible wear with an age-matched control group to determine the extent and effects of dissemination of wear debris. In subjects with stainless-steel and cobalt-chrome prostheses metal was found in local and distant lymph nodes, bone marrow, liver and spleen. The levels were highest in subjects with loose, worn joint prostheses and the main source of the debris was the matt coating. Metal levels were also raised in subjects with implants without visible wear and, to a less extent, in those with dynamic hip screws. Necrosis of lymph nodes was seen in those cases with the most wear, and potential damage to more distant organs such as the bone marrow, liver and spleen in the long term cannot be discounted. The consequences for the immune system and the role of metal dissemination in the possible induction of neoplasia are discussed.
authors.affiliation: Southmead Hospital, England.
authors.forename: C P
authors.initials: CP
authors.lastname: Case
authors.forename: V G
authors.initials: VG
authors.lastname: Langkamer
authors.forename: C
authors.initials: C
authors.lastname: James
authors.forename: M R
authors.initials: MR
authors.lastname: Palmer
authors.forename: A J
authors.initials: AJ
authors.lastname: Kemp
authors.forename: P F
authors.initials: PF
authors.lastname: Heap
authors.forename: L
authors.initials: L
authors.lastname: Solomon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D002102:Cadaver; D002858:Chromium Alloys; D005355:Fibrosis; D005549:Foreign-Body Reaction / Q000209:etiology / Q000473:pathology*; D006622:Hip Prosthesis; D006801:Humans; D007720:Knee Prosthesis; D008198:Lymph Nodes / Q000473:pathology; D008855:Microscopy, Electron, Scanning; D017348:Microscopy, Electron, Scanning Transmission; D008875:Middle Aged; D009336:Necrosis; D009369:Neoplasms / Q000209:etiology / Q000473:pathology; D019736:Prostheses and Implants; D011475:Prosthesis Failure; D013193:Stainless Steel; D014025:Titanium
chemical_list: D002858:Chromium Alloys; D013193:Stainless Steel; D014025:Titanium