title: Orthopaedic metals and their potential toxicity in the arthroplasty patient: A review of current knowledge and future strategies.
abstract: The long-term effects of metal-on-metal arthroplasty are currently under scrutiny because of the potential biological effects of metal wear debris. This review summarises data describing the release, dissemination, uptake, biological activity, and potential toxicity of metal wear debris released from alloys currently used in modern orthopaedics. The introduction of risk assessment for the evaluation of metal alloys and their use in arthroplasty patients is discussed and this should include potential harmful effects on immunity, reproduction, the kidney, developmental toxicity, the nervous system and carcinogenesis.
authors.affiliation: University of Bristol, Bristol Implant Research Centre, Avon Orthopaedic Centre (lower level), Southmead Hospital, Westbury-on-Trym, Bristol, BS10 5NB, UK. Gemma.Keegan@bristol.ac.uk
authors.forename: G M
authors.initials: GM
authors.lastname: Keegan
authors.forename: I D
authors.initials: ID
authors.lastname: Learmonth
authors.forename: C P
authors.initials: CP
authors.lastname: Case
mesh_terms: D001178:Arthroplasty / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D008670:Metals / Q000493:pharmacokinetics / Q000633:toxicity*; D019736:Prostheses and Implants / Q000009:adverse effects*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D018570:Risk Assessment / Q000379:methods / Q000639:trends
chemical_list: D008670:Metals