Cobalt from metal-on-metal hip replacements may be the clinically relevant active agent responsible for periprosthetic tissue reactions.
Some types of metal-on-metal (MOM) hip replacements have unacceptably high rates of failure, such as the Ultima TPS MOM hip, with 13.8% failure at 5 years. This has been attributed to an inflammatory reaction following the release of cobalt (Co) and chromium (Cr) from the bearing surfaces and modular junctions. There is in vitro evidence that Co is more important than Cr in the inflammatory process, but there are no reported human tissue studies of the analysis of implant-derived metals.
Department of Orthopaedic Surgery, Imperial College and Imperial College Healthcare NHS Trust, Charing Cross Hospital Campus, London, UK. a.hart@ucl.ac.uk
Alister J
AJ
Hart
Paul D
PD
Quinn
Ferdinand
F
Lali
Barry
B
Sampson
John A
JA
Skinner
Jonathan J
JJ
Powell
John
J
Nolan
Keith
K
Tucker
Simon
S
Donell
Adrienne
A
Flanagan
J Fred W
JF
Mosselmans
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D002857:Chromium / Q000737:chemistry; D003035:Cobalt / Q000737:chemistry*; D005260:Female; D006621:Hip Joint / Q000473:pathology*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D061825:Metal-on-Metal Joint Prostheses / Q000009:adverse effects*; D008875:Middle Aged; D013052:Spectrometry, X-Ray Emission; D056928:X-Ray Absorption Spectroscopy
D002857:Chromium; D003035:Cobalt