title: Adverse reactions to metal-on-metal implants.
abstract: New data demonstrate that cobalt ions promote immune system activation through Toll-like receptor 4 signalling. This finding adds to our understanding of the adverse innate and adaptive immune reactions evoked by debris released from metal-on-metal total or resurfacing joint replacement implants, which have provoked recommendations against their use.
authors.affiliation: Department of Medicine, Institute of Clinical Medicine, BMH1, P.O. Box 700, FI-00029 HUS, Finland. yrjo.konttinen@helsinki.fi
authors.forename: Yrjö T
authors.initials: YT
authors.lastname: Konttinen
authors.forename: Jukka
authors.initials: J
authors.lastname: Pajarinen
mesh_terms: D000469:Alkaline Phosphatase / Q000096:biosynthesis*; D000818:Animals; D003035:Cobalt / Q000009:adverse effects*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D051197:Toll-Like Receptor 4 / Q000378:metabolism*
chemical_list: D051197:Toll-Like Receptor 4; D003035:Cobalt; D000469:Alkaline Phosphatase