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Ajibo DN, Orish CN, Ruggieri F, Bocca B, Battistini B, Frazzoli C, Orish FC, Orisakwe OE. An Update Overview on Mechanistic Data and Biomarker Levels in Cobalt and Chromium-Induced Neurodegenerative Diseases. Biol Trace Elem Res 2024; 202:3538-3564. [PMID: 38017235 DOI: 10.1007/s12011-023-03965-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/12/2023] [Indexed: 11/30/2023]
Abstract
There is increasing evidence that the imbalance of metals as cobalt (Co) and chromium (Cr) may increase the risk of development and progression of neurodegenerative diseases (NDDs). The human exposure to Co and Cr is derived mostly from industry, orthopedic implants, and polluted environments. Neurological effects of Co and Cr include memory deficit, olfactory dysfunction, spatial disorientation, motor neuron disease, and brain cancer. Mechanisms of Co and Cr neurotoxicity included DNA damage and genomic instability, epigenetic changes, mitochondrial disturbance, lipid peroxidation, oxidative stress, inflammation, and apoptosis. This paper seeks to overview the Co and Cr sources, the mechanisms by which these metals induce NDDs, and their levels in fluids of the general population and patients affected by NDDs. To this end, evidence of Co and Cr unbalance in the human body, mechanistic data, and neurological symptoms were collected using in vivo mammalian studies and human samples.
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Affiliation(s)
- Doris Nnena Ajibo
- Department of Experimental Pharmacology & Toxicology, Faculty of Pharmacy, University of Port Harcourt, PMB, 5323, Port Harcourt, Rivers State, Nigeria
| | - Chinna Nneka Orish
- Department of Anatomy, College of Health Sciences University of Port Harcourt, PMB, 5323, Port Harcourt, Rivers State, Nigeria
| | - Flavia Ruggieri
- Department of Environment and Health, Istituto Superiore Di Sanità, Rome, Italy
| | - Beatrice Bocca
- Department of Environment and Health, Istituto Superiore Di Sanità, Rome, Italy
| | - Beatrice Battistini
- Department of Environment and Health, Istituto Superiore Di Sanità, Rome, Italy
| | - Chiara Frazzoli
- Department for Cardiovascular, Endocrine-Metabolic Diseases, and Aging, Istituto Superiore Di Sanità, Rome Viale Regina Elena, 29900161, Rome, Italy
| | | | - Orish E Orisakwe
- Department of Experimental Pharmacology & Toxicology, Faculty of Pharmacy, University of Port Harcourt, PMB, 5323, Port Harcourt, Rivers State, Nigeria.
- African Centre of Excellence for Public Health and Toxicological Research (ACE-PUTOR), University of Port Harcourt, PMB, 5323, Port Harcourt, Rivers State, Nigeria.
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2
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Zhong Q, Pan X, Chen Y, Lian Q, Gao J, Xu Y, Wang J, Shi Z, Cheng H. Prosthetic Metals: Release, Metabolism and Toxicity. Int J Nanomedicine 2024; 19:5245-5267. [PMID: 38855732 PMCID: PMC11162637 DOI: 10.2147/ijn.s459255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/13/2024] [Indexed: 06/11/2024] Open
Abstract
The development of metallic joint prostheses has been ongoing for more than a century alongside advancements in hip and knee arthroplasty. Among the materials utilized, the Cobalt-Chromium-Molybdenum (Co-Cr-Mo) and Titanium-Aluminum-Vanadium (Ti-Al-V) alloys are predominant in joint prosthesis construction, predominantly due to their commendable biocompatibility, mechanical strength, and corrosion resistance. Nonetheless, over time, the physical wear, electrochemical corrosion, and inflammation induced by these alloys that occur post-implantation can cause the release of various metallic components. The released metals can then flow and metabolize in vivo, subsequently causing potential local or systemic harm. This review first details joint prosthesis development and acknowledges the release of prosthetic metals. Second, we outline the metallic concentration, biodistribution, and elimination pathways of the released prosthetic metals. Lastly, we discuss the possible organ, cellular, critical biomolecules, and significant signaling pathway toxicities and adverse effects that arise from exposure to these metals.
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Affiliation(s)
- Qiang Zhong
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Xin Pan
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Yuhang Chen
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Qiang Lian
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Jian Gao
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Yixin Xu
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Jian Wang
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Zhanjun Shi
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Hao Cheng
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
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3
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Ebinger K, Samelko L, Radice S, Hallab NJ, Wimmer MA. Translational Characterization of Macrophage Responses to Stable and Non-Stable CoCrMo Wear and Corrosion Debris Generated In-Situ for Total Hip Replacement. BIOTRIBOLOGY (OXFORD) 2023; 35-36:100259. [PMID: 37900899 PMCID: PMC10611437 DOI: 10.1016/j.biotri.2023.100259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Metal wear and corrosion debris remain a limiting factor for long-term durability of total hip replacement (THR). Common wear particle production techniques for research differ from the actual tribocorrosion processes at the implant site, potentially causing loss of valuable information. The aim of this study was to investigate reactions to freshly generated and time-stabilized particles and ions released from CoCrMo-alloy using a bio-tribometer, which mimics conditions of the periprosthetic environment. THP-1 macrophages were challenged with freshly produced or time-stabilized wear debris. Wear generation took place in a custom-built bio-tribometer inside a CO2 incubator operating with a reciprocating rotation of an Al2O3 ball against a CoCrMo disc. Two different electrochemical conditions with increasingly forced corrosion rates were tested: +0.45 V (passive domain) and +0.67 V (transition to transpassive domain). Cell viability, proinflammatory cytokines, electrochemical measurements and ICP-MS metal ion content analyses were performed. Cobalt/ chromium concentrations were 6.6/ 1.6 ppm in the passive domain and almost doubled to 11.4/ 3.0 ppm in the passive-transpassive domain. Under those electrochemical conditions, freshly produced and time-stabilized CoCrMo wear decreased cell viability to the same extent. Secretion of proinflammatory cytokines were not significantly different for freshly produced and time-stabilized debris. This study suggests that freshly generated and time-stabilized metal particles/ions cause similar toxicity and inflammatory reactions in macrophages, indicating that standard practices for generating wear debris are valid methods to evaluate wear particle disease. Other cell types, materials, and corrosion potentials need to be studied in the future to solidify the conclusion.
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Affiliation(s)
- Kathrin Ebinger
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612
- Klinikum Garmisch-Partenkirchen, Auenstraße 6, 82467 Garmisch-Partenkirchen Germany
| | - Lauryn Samelko
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612
| | - Simona Radice
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612
| | - Nadim J Hallab
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612
| | - Markus A Wimmer
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612
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4
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Avery D, Morandini L, Celt N, Bergey L, Simmons J, Martin RK, Donahue HJ, Olivares-Navarrete R. Immune cell response to orthopedic and craniofacial biomaterials depends on biomaterial composition. Acta Biomater 2023; 161:285-297. [PMID: 36905954 PMCID: PMC10269274 DOI: 10.1016/j.actbio.2023.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/20/2023] [Accepted: 03/05/2023] [Indexed: 03/11/2023]
Abstract
Materials for craniofacial and orthopedic implants are commonly selected based on mechanical properties and corrosion resistance. The biocompatibility of these materials is typically assessed in vitro using cell lines, but little is known about the response of immune cells to these materials. This study aimed to evaluate the inflammatory and immune cell response to four common orthopedic materials [pure titanium (Ti), titanium alloy (TiAlV), 316L stainless steel (SS), polyetheretherketone (PEEK)]. Following implantation into mice, we found high recruitment of neutrophils, pro-inflammatory macrophages, and CD4+ T cells in response to PEEK and SS implants. Neutrophils produced higher levels of neutrophil elastase, myeloperoxidase, and neutrophil extracellular traps in vitro in response to PEEK and SS than neutrophils on Ti or TiAlV. Macrophages co-cultured on PEEK, SS, or TiAlV increased polarization of T cells towards Th1/Th17 subsets and decreased Th2/Treg polarization compared to Ti substrates. Although SS and PEEK are considered biocompatible materials, both induce a more robust inflammatory response than Ti or Ti alloy characterized by high infiltration of neutrophils and T cells, which may cause fibrous encapsulation of these materials. STATEMENT OF SIGNIFICANCE: Materials for craniofacial and orthopedic implants are commonly selected based on their mechanical properties and corrosion resistance. This study aimed to evaluate the immune cell response to four common orthopedic and craniofacial biomaterials: pure titanium, titanium-aluminum-vanadium alloy, 316L stainless steel, and PEEK. Our results demonstrate that while the biomaterials tested have been shown to be biocompatible and clinically successful, the inflammatory response is largely driven by chemical composition of the biomaterials.
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Affiliation(s)
- Derek Avery
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA, United States
| | - Lais Morandini
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA, United States
| | - Natalie Celt
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA, United States
| | - Leah Bergey
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA, United States
| | - Jamelle Simmons
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA, United States
| | - Rebecca K Martin
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Henry J Donahue
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA, United States
| | - Rene Olivares-Navarrete
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA, United States.
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Pechancová R, Gallo J, Baron D, Milde D, Antal P, Slobodová Z, Lemr K, Pluháček T. Detailed insight into chromium species released from failed CoCrMo implants: Ex vivo periprosthetic tissues study. J Biomed Mater Res B Appl Biomater 2023; 111:271-283. [PMID: 36507699 DOI: 10.1002/jbm.b.35149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 07/26/2022] [Accepted: 08/01/2022] [Indexed: 12/15/2022]
Abstract
This unique study provides information on Cr species and their distribution in periprosthetic tissues of patients with metal-on-polyethylene joint implants. Co-Cr-Mo alloy has been widely used in joint replacement and represents a source of metal derived species. In the case of chromium, previous studies on periprosthetic tissues revealed mainly Cr(III) distribution, whereas the potential release of carcinogenic Cr(VI) species has been still a subject of debate. Here, an analytical approach utilizing speciation and fractionation was developed to analyze periprosthetic tissue samples collected from wide range of patients with failed total hip or knee replacements. The results reveal that Cr(III) is mainly released in the form of insoluble CrPO4 and Cr2 O3 particles. The highest Cr contents were found in periprosthetic tissues of patients suffering from aseptic loosening and having more Cr-based implants in the body. Cr species penetrated tissue layers, but their levels decreased with the distance from an implant. The detailed speciation/fractionation study carried out using the set of consecutive periprosthetic tissues of a patient with extensive metallosis showed the presence of trace amounts of free Cr(III), nanoparticles, and metal-protein complexes, but the majority of Cr still occurred in CrPO4 form. Carcinogenic Cr(VI) species were not detected. Up to date, there is no published human tissue study focused on the detailed speciation of both soluble and insoluble Cr-based species in the context of failing total hip and knee replacements.
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Affiliation(s)
- Radka Pechancová
- Department of Analytical Chemistry, Faculty of Science, Palacký University Olomouc, Olomouc, Czech Republic
| | - Jiří Gallo
- Department of Orthopedics, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
| | - Daniel Baron
- Department of Analytical Chemistry, Faculty of Science, Palacký University Olomouc, Olomouc, Czech Republic
| | - David Milde
- Department of Analytical Chemistry, Faculty of Science, Palacký University Olomouc, Olomouc, Czech Republic
| | - Peter Antal
- Department of Inorganic Chemistry, Faculty of Science, Palacký University Olomouc, Olomouc, Czech Republic
| | - Zuzana Slobodová
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Karel Lemr
- Department of Analytical Chemistry, Faculty of Science, Palacký University Olomouc, Olomouc, Czech Republic.,Institute of Microbiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Tomáš Pluháček
- Department of Analytical Chemistry, Faculty of Science, Palacký University Olomouc, Olomouc, Czech Republic
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Bodiga VL, Vemuri PK, Kudle MR, Bodiga S. Ellagic Acid from Terminalia arjuna Fruits Protects Against Chromium and Cobalt Toxicity in Primary Human Lymphocytes. Biol Trace Elem Res 2022; 200:2698-2708. [PMID: 34432268 DOI: 10.1007/s12011-021-02900-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/21/2021] [Indexed: 12/28/2022]
Abstract
Increased accumulation of heavy metal ions such as Cr6+ and Co2+ due to release from prostheses and metallic implants has been reported. These metal ions have been shown to affect both resting and activated lymphocytes. Natural remedies towards mitigating the cytotoxic effects of metal ions are clearly warranted. Polyphenolic compounds which are part of hydrolysable tannins from natural plant sources are considered effective in cheating heavy metal ions in a biological system. We have isolated and characterized a polyphenolic compound (ellagic acid) from Terminalia arjuna fruits that has been tested for its ability to attenuate the metal ion toxicity in primary human lymphocytes in culture. Cr6+ and Co2+ (100 μM) decreased lymphocyte viability and proliferation and increased apoptosis of resting as well as CD3 and/or CD28-stimulated lymphocytes. Metal ions markedly diminished the cytokine (interleukin-2 and interferon-γ) secretion from activated lymphocytes. Pretreatment with ellagic acid at 25, 50, and 100 μM concentrations effectively improved viability and proliferative responses of both resting and activated lymphocytes, while attenuating the apoptotic index. Ellagic acid also tended to normalize the cytokine secretion from the activated lymphocytes even in the presence of metal ions, suggesting broad effects on the adaptive immune system.
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Affiliation(s)
- Vijaya Lakshmi Bodiga
- Department of Biochemistry and Molecular Biology, Institute of Genetics & Hospital for Genetic Diseases, Osmania University, Begumpet, Hyderabad, Telangana, India
| | - Praveen Kumar Vemuri
- Department of Biotechnology, Koneru Lakshmaiah University, Green Fields, Vaddeswaram, Guntur, Andhra Pradesh, India
| | - Madhukar Rao Kudle
- Department of Biochemistry, Kakatiya University, Warangal, Telangana, India
| | - Sreedhar Bodiga
- Laboratory of Biochemistry, Department of Basic Sciences, Forest College and Research Institute Hyderabad, Siddipet District Telangana, Mulugu, India.
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Metallic Implants Used in Lumbar Interbody Fusion. MATERIALS 2022; 15:ma15103650. [PMID: 35629676 PMCID: PMC9146470 DOI: 10.3390/ma15103650] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 02/07/2023]
Abstract
Over the last decade, pedicle fixation systems have evolved and modifications in spinal fusion techniques have been developed to increase fusion rates and improve clinical outcomes after lumbar interbody fusion (LIF). Regarding materials used for screw and rod manufacturing, metals, especially titanium alloys, are the most popular resources. In the case of pedicle screws, that biomaterial can be also doped with hydroxyapatite, CaP, ECM, or tantalum. Other materials used for rod fabrication include cobalt-chromium alloys and nitinol (nickel-titanium alloy). In terms of mechanical properties, the ideal implant used in LIF should have high tensile and fatigue strength, Young's modulus similar to that of the bone, and should be 100% resistant to corrosion to avoid mechanical failures. On the other hand, a comprehensive understanding of cellular and molecular pathways is essential to identify preferable characteristics of implanted biomaterial to obtain fusion and avoid implant loosening. Implanted material elicits a biological response driven by immune cells at the site of insertion. These reactions are subdivided into innate (primary cellular response with no previous exposure) and adaptive (a specific type of reaction induced after earlier exposure to the antigen) and are responsible for wound healing, fusion, and also adverse reactions, i.e., hypersensitivity. The main purposes of this literature review are to summarize the physical and mechanical properties of metal alloys used for spinal instrumentation in LIF which include fatigue strength, Young's modulus, and corrosion resistance. Moreover, we also focused on describing biological response after their implantation into the human body. Our review paper is mainly focused on titanium, cobalt-chromium, nickel-titanium (nitinol), and stainless steel alloys.
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Maitama MI, Lawal YZ, Dahiru IL, Alabi IA, Amaefule KE, Audu SS, Ibrahim A. Implant factors that might influence components' survival in primary total hip arthroplasty. Niger Postgrad Med J 2022; 29:1-5. [PMID: 35102943 DOI: 10.4103/npmj.npmj_726_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Primary total hip arthroplasty (THA) is an invaluable surgical procedure that has revolutionised the treatment of various end-stage hip pathologies. Aseptic loosening of either acetabular cup and/or femoral stem as well as components' dislocation are well-known post-operative complications due to so many factors: environmental, surgeon, patient related, disease related or implant design. The aim of this literature review is to look at some relevant implant designs that might influence acetabular and femoral components' survival for primary cementless THA using revision for aseptic loosening and dislocation as criteria for failure. This may also assist the surgeon in making an informed choice of using appropriate implants to match the demographic and disease-specific need of the patients undergoing the surgical procedure. This review article was performed using an online literature search on relevant publications.
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Affiliation(s)
- Mohammed Inuwa Maitama
- Department of Trauma and Orthopedic Surgery, Ahmadu Bello University Zaria, Kaduna State, Nigeria
| | - Yau Zakari Lawal
- Department of Trauma and Orthopedic Surgery, Ahmadu Bello University Zaria, Kaduna State, Nigeria
| | - Ismaila Lawal Dahiru
- Department of Trauma and Orthopedic Surgery, Ahmadu Bello University Zaria, Kaduna State, Nigeria
| | - Ibrahim Abolaji Alabi
- Department of Trauma and Orthopedic Surgery, National Orthopedic Hospital Dala, Kano State, Nigeria
| | - Kenneth Ezenwa Amaefule
- Department of Trauma and Orthopedic Surgery, Ahmadu Bello University Zaria, Kaduna State, Nigeria
| | - Simpa Siaka Audu
- Department of Trauma and Orthopedic Surgery, Ahmadu Bello University Zaria, Kaduna State, Nigeria
| | - Aniko Ibrahim
- Department of Trauma and Orthopedic Surgery, Ahmadu Bello University Zaria, Kaduna State, Nigeria
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Badhe RV, Akinfosile O, Bijukumar D, Barba M, Mathew MT. Systemic toxicity eliciting metal ion levels from metallic implants and orthopedic devices - A mini review. Toxicol Lett 2021; 350:213-224. [PMID: 34252509 DOI: 10.1016/j.toxlet.2021.07.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 06/19/2021] [Accepted: 07/07/2021] [Indexed: 12/28/2022]
Abstract
The metal/metal alloy-based implants and prostheses are in use for over a century, and the rejections, revisions, and metal particle-based toxicities were reported concurrently. Complications developed due to metal ions, metal debris, and organo-metallic particles in orthopedic patients have been a growing concern in recent years. It was reported that local and systemic toxicity caused by such released products from the implants is one of the major reasons for implant rejection and revision. Even though the description of environmental metal toxicants and safety limits for their exposure to humans were well established in the literature, an effort was not adequately performed in the case of implant-based metal toxicology. Since the metal ion concentration in serum acts as a possible indicator of the systemic toxicity, this review summarizes the reported human serum safe limits, toxic limits, and concentration range (μg/L, ppb, etc.) for mild to severe symptoms of six (cardiac, hepatic, neuro, nephron, dermal and endocrine) systemic toxicities for twelve most commonly used metallic implants. It also covers the widely used metal ion quantification techniques and systemic toxicity treatments reported.
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Affiliation(s)
- Ravindra V Badhe
- Department of Biomedical Sciences, University of Illinois College of Medicine at Rockford, Rockford, IL, USA
| | - Obakanyin Akinfosile
- Department of Biomedical Sciences, University of Illinois College of Medicine at Rockford, Rockford, IL, USA
| | - Divya Bijukumar
- Department of Biomedical Sciences, University of Illinois College of Medicine at Rockford, Rockford, IL, USA
| | | | - Mathew T Mathew
- Department of Biomedical Sciences, University of Illinois College of Medicine at Rockford, Rockford, IL, USA.
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Umar M, Jahangir N, Khan MF, Saeed Z, Sultan F, Sultan A. Cobalt-related cardiomyopathy: A real concern! A review of published evidence. J Orthop Surg (Hong Kong) 2021; 28:2309499020905993. [PMID: 32410523 DOI: 10.1177/2309499020905993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Cobalt (Co) toxicity-related cardiomyopathy (CMP) in hip arthroplasty has recently been reported in the literature. The purpose of this review was to identify and assess available published evidence of CMP in hip arthroplasty patients and to derive recommendations for management. METHODS We evaluated 23 cases reported till October 2018 and stratified into three categories, based on pre-existing risk factors for CMP, histological confirmation and evidence of systemic signs of Co toxicity. RESULTS Co toxicity was considered to be the definite cause of CMP in 8 cases and probably contributory in 13 cases. Two cases were considered to have developed CMP secondary to pre-existing risk factors. Majority of the patients had good recovery of cardiac function after hip revision and cardiac management, but five cases deteriorated and died. CONCLUSION Although Co-related CMP has been reported in a small number of cases of hip arthroplasty, a delay or missed diagnosis may lead to significant morbidity and mortality. Timely diagnosis, removal of causative implant and avoidance of metal articulations in revision for fractured ceramic implants may help in effective management.
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Affiliation(s)
- Muhammad Umar
- Macclesfield District General Hospital, Macclesfield, UK
| | | | | | - Zobia Saeed
- Macclesfield District General Hospital, Macclesfield, UK
| | - Farina Sultan
- Wrightington, Wigan & Leigh NHS Foundation Trust, Wigan, UK
| | - Ayyaz Sultan
- Wrightington, Wigan & Leigh NHS Foundation Trust, Wigan, UK
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11
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Tran TTT, Kannoorpatti K, Padovan A, Thennadil S. A study of bacteria adhesion and microbial corrosion on different stainless steels in environment containing Desulfovibrio vulgaris. ROYAL SOCIETY OPEN SCIENCE 2021; 8:201577. [PMID: 33614090 PMCID: PMC7890485 DOI: 10.1098/rsos.201577] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/20/2020] [Indexed: 06/12/2023]
Abstract
Stainless steel is an important material used in many applications due to its mechanical strength and corrosion-resistant properties. The high corrosion resistance of stainless steel is provided by the passive film. Different stainless steels have different alloy elements and surface properties which could have a significant influence on bacterial attachment to the surface and thus might result in different microbial corrosion behaviours. In this study, the effect of adhesion of sulfate-reducing bacteria (SRB) on corrosion behaviour in artificial seawater on different stainless steels was investigated. Stainless steel materials used were SS 410, SS 420, SS 316 and DSS 2205 and pure chromium. The contact angle was measured to study the effect of surface properties of materials. Adhesion was measured by counting cells attached to the surface of materials. The corrosion behaviour of the materials was measured by electrochemical testing including measuring open circuit potential, electrochemical impedance spectroscopy and potentiodynamic behaviour. The long-term corrosion behaviour of each material was studied after six months of exposure by measuring weight loss and surface analysis with scanning electron microscope with energy-dispersive X-ray analysis. Hydrophobicity had a strong effect on bacterial attachment. Alloying elements e.g. nickel also had shown its ability to attract bacteria to adhere on the surface. However, the corrosion rate of different materials is determined not only by bacterial attachment but also by the stability of the passive film which is determined by the alloying elements, such as Mo and Cr. Chromium showed high resistance to corrosion, possibly due to toxicity on bacterial attachment. The nature of bacterial attachment and corrosion behaviour of the materials are discussed.
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Affiliation(s)
- T. T. T. Tran
- Energy and Resources Institute, College of Engineering, Information Technology and Environment, Charles Darwin University, Darwin, Northern Territory 0909, Australia
| | - K. Kannoorpatti
- Energy and Resources Institute, College of Engineering, Information Technology and Environment, Charles Darwin University, Darwin, Northern Territory 0909, Australia
| | - A. Padovan
- Research Institute for the Environment and Livelihoods, College of Engineering, Information Technology and Environment, Charles Darwin University, Darwin, Northern Territory 0909, Australia
| | - S. Thennadil
- Energy and Resources Institute, College of Engineering, Information Technology and Environment, Charles Darwin University, Darwin, Northern Territory 0909, Australia
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12
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Cullom AC, Martin RL, Song Y, Williams K, Williams A, Pruden A, Edwards MA. Critical Review: Propensity of Premise Plumbing Pipe Materials to Enhance or Diminish Growth of Legionella and Other Opportunistic Pathogens. Pathogens 2020; 9:E957. [PMID: 33212943 PMCID: PMC7698398 DOI: 10.3390/pathogens9110957] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 12/20/2022] Open
Abstract
Growth of Legionella pneumophila and other opportunistic pathogens (OPs) in drinking water premise plumbing poses an increasing public health concern. Premise plumbing is constructed of a variety of materials, creating complex environments that vary chemically, microbiologically, spatially, and temporally in a manner likely to influence survival and growth of OPs. Here we systematically review the literature to critically examine the varied effects of common metallic (copper, iron) and plastic (PVC, cross-linked polyethylene (PEX)) pipe materials on factors influencing OP growth in drinking water, including nutrient availability, disinfectant levels, and the composition of the broader microbiome. Plastic pipes can leach organic carbon, but demonstrate a lower disinfectant demand and fewer water chemistry interactions. Iron pipes may provide OPs with nutrients directly or indirectly, exhibiting a high disinfectant demand and potential to form scales with high surface areas suitable for biofilm colonization. While copper pipes are known for their antimicrobial properties, evidence of their efficacy for OP control is inconsistent. Under some circumstances, copper's interactions with premise plumbing water chemistry and resident microbes can encourage growth of OPs. Plumbing design, configuration, and operation can be manipulated to control such interactions and health outcomes. Influences of pipe materials on OP physiology should also be considered, including the possibility of influencing virulence and antibiotic resistance. In conclusion, all known pipe materials have a potential to either stimulate or inhibit OP growth, depending on the circumstances. This review delineates some of these circumstances and informs future research and guidance towards effective deployment of pipe materials for control of OPs.
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Affiliation(s)
- Abraham C. Cullom
- Civil and Environmental Engineering, Virginia Tech, 1145 Perry St., 418 Durham Hall, Blacksburg, VA 24061, USA; (A.C.C.); (R.L.M.); (Y.S.); (A.P.)
| | - Rebekah L. Martin
- Civil and Environmental Engineering, Virginia Tech, 1145 Perry St., 418 Durham Hall, Blacksburg, VA 24061, USA; (A.C.C.); (R.L.M.); (Y.S.); (A.P.)
- Civil and Environmental Engineering, Virginia Military Institute, Lexington, VA 24450, USA
| | - Yang Song
- Civil and Environmental Engineering, Virginia Tech, 1145 Perry St., 418 Durham Hall, Blacksburg, VA 24061, USA; (A.C.C.); (R.L.M.); (Y.S.); (A.P.)
| | | | - Amanda Williams
- c/o Marc Edwards, Civil and Environmental Engineering, Virginia Tech, 1145 Perry St., 418 Durham Hall, Blacksburg, VA 24061, USA;
| | - Amy Pruden
- Civil and Environmental Engineering, Virginia Tech, 1145 Perry St., 418 Durham Hall, Blacksburg, VA 24061, USA; (A.C.C.); (R.L.M.); (Y.S.); (A.P.)
| | - Marc A. Edwards
- Civil and Environmental Engineering, Virginia Tech, 1145 Perry St., 418 Durham Hall, Blacksburg, VA 24061, USA; (A.C.C.); (R.L.M.); (Y.S.); (A.P.)
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13
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Effects of bovine serum albumin and hyaluronic acid on the electrochemical response of a CoCrMo alloy to cathodic and anodic excursions. ACTA ACUST UNITED AC 2019; 5. [PMID: 31828005 DOI: 10.1007/s40735-019-0299-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The problem of wear and corrosion of CoCrMo-implant surfaces in the human body following total joint replacement has been commonly investigated with tribocorrosion tests, using different lubricants meant to simulate the pseudo-synovial fluid. While results considering the synovial fluid components separately have highlighted their individual influence on the tribological performance of CoCrMo-alloy, an understanding about the influence of the synovial fluid components under the electrochemical point of view is missing. This work aims to investigate the effect of bovine serum albumin (BSA) and hyaluronic acid (HA) on electrochemical potential variations of CoCrMo alloys tested in a model synovial fluid. To simulate the environment inside the synovial capsule, the tests were performed inside a CO2 incubator at 37°C. Open circuit potential, electrochemical impedance spectroscopy, cathodic and anodic potentiodynamic measurements were performed with different electrolytes, prepared with cell culture medium (RMPI-1640), BSA and HA. The final CoCrMo-surface was analyzed by SEM/EDS and infrared spectroscopy. The influence of HA on the corrosion of the CoCrMo-alloy depended on the presence of BSA proteins adsorbed on the CoCrMo-surface: EIS and anodic polarization results showed a corrosive action of HA in the absence of adsorbed proteins. In the presence of both BSA and HA, organometallic precipitates were found on the CoCrMo surface following reverse anodic polarization, which remind of corrosion products found in-vivo. These results indicate that HA affects the interaction of CoCrMo implant alloys with protein-containing model synovial fluids, and suggest that HA needs to be considered in tribocorrosion studies for more clinically relevant outcomes.
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Stojanović B, Bauer C, Stotter C, Klestil T, Nehrer S, Franek F, Rodríguez Ripoll M. Tribocorrosion of a CoCrMo alloy sliding against articular cartilage and the impact of metal ion release on chondrocytes. Acta Biomater 2019; 94:597-609. [PMID: 31226479 DOI: 10.1016/j.actbio.2019.06.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 01/22/2023]
Abstract
Partial knee replacement and hemiarthroplasty are some of the orthopedic procedures resulting in a metal on cartilage interface. As metal implant material, CoCrMo based alloys are commonly used. The aim of the present study is to assess the role of biotribocorrosion on the CoCrMo-cartilage interface with an emphasis on metal release during sliding contact. The biotribocorrosion experiments were performed under controlled electrochemical conditions using a floating cell with a three electrode set up coupled to a microtribometer. Throughout the experiment the coefficient of friction and the open circuit potential were monitored. Analyses of the electrolyte after the experiment show that metal release can occur during sliding contact of CoCrMo alloy against articular cartilage despite the extraordinary low coefficient of friction measured. Metal release is attributed to changes in passive layer caused at the onset of sliding. The released metal was found to be forming compounds with potential cytotoxicity. Since the presence of metal ions in the cartilage matrix can potentially lead to cell apoptosis, the metabolic activity of human osteoarthritic chondrocytes (2D-cultures) was investigated in the presence of phosphate buffered saline containing metal ions using XTT-assay. The experiments indicate that critical concentrations of Co ions lead to a significant decrease in chondrocyte metabolic activity. Therefore, biotribocorrosion is a mechanism that can occur in partial replacements and lead to chondrocyte apoptosis thus playing a role in the observed accelerated degradation of the remaining cartilage tissue after the mentioned orthopedic procedures. STATEMENT OF SIGNIFICANCE: Partial replacements provide an alternative to total joint replacements. This procedure is less invasive, allows a faster rehabilitation and provides a better function of the joint. However, the remaining native cartilage experiences accelerated degradation when in contact with metallic implant components. This work investigates the role of tribocorrosion at the metal-cartilage interface during sliding. Tribocorrosion is a degradation process that can alter significantly the wear rates experienced by metallic implants and lead to the release of metal ions and particles. The released metal can form compounds with potential cytotoxicity on cartilage tissue. The knowledge gained in this work will serve to understand the mechanisms behind the failure of partial replacements and develop future biomaterials with an enhanced lifetime.
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Affiliation(s)
- B Stojanović
- AC2T research GmbH, Viktor Kaplan-Straße 2/C, A-2700 Wiener Neustadt, Austria
| | - C Bauer
- Danube University Krems, Faculty of Health and Medicine, Department for Health Sciences and Biomedicine, Center for Regenerative Medicine and Orthopedics, Dr. Karl-Dorrek-Str. 30, A-3500 Krems, Austria
| | - C Stotter
- Danube University Krems, Faculty of Health and Medicine, Department for Health Sciences and Biomedicine, Center for Regenerative Medicine and Orthopedics, Dr. Karl-Dorrek-Str. 30, A-3500 Krems, Austria; LK Baden-Mödling-Hainburg, Department of Orthopedics and Traumatology, Waltersdorferstraße 75, A-2500 Baden, Austria
| | - T Klestil
- LK Baden-Mödling-Hainburg, Department of Orthopedics and Traumatology, Waltersdorferstraße 75, A-2500 Baden, Austria; Danube University Krems, Faculty of Health and Medicine, Department for Health Sciences and Biomedicine, Center for Medical Specializations, Dr. Karl-Dorrek-Str. 30, A-3500 Krems, Austria
| | - S Nehrer
- Danube University Krems, Faculty of Health and Medicine, Department for Health Sciences and Biomedicine, Center for Regenerative Medicine and Orthopedics, Dr. Karl-Dorrek-Str. 30, A-3500 Krems, Austria
| | - F Franek
- AC2T research GmbH, Viktor Kaplan-Straße 2/C, A-2700 Wiener Neustadt, Austria
| | - M Rodríguez Ripoll
- AC2T research GmbH, Viktor Kaplan-Straße 2/C, A-2700 Wiener Neustadt, Austria.
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15
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Umar M, Jahangir N, Faisal Khan M, Saeed Z, Sultan F, Sultan A. Cobalt cardiomyopathy in hip arthroplasty. Arthroplast Today 2019; 5:371-375. [PMID: 31516984 PMCID: PMC6728440 DOI: 10.1016/j.artd.2019.04.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/26/2019] [Accepted: 04/27/2019] [Indexed: 01/25/2023] Open
Abstract
Background Cobalt toxicity-related cardiomyopathy in hip arthroplasty has recently been reported in the literature. The purpose of this review is to identify and assess available published evidence of cardiomyopathy in hip arthroplasty patients and to derive recommendations for management. Methods We evaluated 23 cases reported until October 2018 and stratified them into 3 categories, based upon pre-existing risk factors for cardiomyopathy, histological confirmation, and evidence of systemic signs of cobalt toxicity. Results Cobalt toxicity was considered to be the definite cause of cardiomyopathy in 8 cases, and probably contributory in 13 cases. Two cases were considered to have developed cardiomyopathy secondary to pre-existing risk factors. Majority of the patients had a good recovery of cardiac function after hip revision and cardiac management, but 5 cases deteriorated and died. Conclusions Although cobalt-related cardiomyopathy has been reported in a small number of cases of hip arthroplasty, a delay or missed diagnosis may lead to significant morbidity and mortality. Timely diagnosis, removal of causative implant, and avoidance of metal articulations in revision for fractured ceramic implants may help in an effective management.
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Affiliation(s)
- Muhammad Umar
- Department of Trauma and Orthopaedics, Macclesfield District General Hospital, Macclesfield, UK
| | - Noman Jahangir
- Department of Trauma and Orthopaedics, Wythenshawe Hospital, Manchester, UK
| | | | - Zobia Saeed
- Department of Trauma and Orthopaedics, Macclesfield District General Hospital, Macclesfield, UK
| | - Farina Sultan
- Department of Cardiology, Royal Albert Edward Infirmary Wrightington, Wigan & Leigh NHS Foundation Trust, Wigan, UK
| | - Ayyaz Sultan
- Department of Cardiology, Royal Albert Edward Infirmary Wrightington, Wigan & Leigh NHS Foundation Trust, Wigan, UK
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16
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Langton DJ, Natu S, Harrington CF, Bowsher JG, Nargol AVF. Is the synovial fluid cobalt-to-chromium ratio related to the serum partitioning of metal debris following metal-on-metal hip arthroplasty? Bone Joint Res 2019; 8:146-155. [PMID: 30997040 PMCID: PMC6444018 DOI: 10.1302/2046-3758.83.bjr-2018-0049.r1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives We investigated the reliability of the cobalt-chromium (CoCr) synovial joint fluid ratio (JFR) in identifying the presence of a severe aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL) response and/or suboptimal taper performance (SOTP) following metal-on-metal (MoM) hip arthroplasty. We then examined the possibility that the CoCr JFR may influence the serum partitioning of Co and Cr. Methods For part A, we included all revision surgeries carried out at our unit with the relevant data, including volumetric wear analysis, joint fluid (JF) Co and Cr concentrations, and ALVAL grade (n = 315). Receiver operating characteristic curves were constructed to assess the reliability of the CoCr JFR in identifying severe ALVAL and/or SOTP. For part B, we included only patients with unilateral prostheses who had given matched serum and whole blood samples for Co and Cr analysis (n = 155). Multiple regression was used to examine the influence of JF concentrations on the serum partitioning of Co and Cr in the blood. Results A CoCr JFR > 1 showed a specificity of 83% (77% to 88%) and sensitivity of 63% (55% to 70%) for the detection of severe ALVAL and/or SOTP. In patients with CoCr JFRs > 1, the median blood Cr to serum Cr ratio was 0.99, compared with 0.71 in patients with CoCr JFRs < 1 (p < 0.001). Regression analysis demonstrated that the blood Cr to serum Cr value was positively associated with the JF Co concentration (p = 0.011) and inversely related to the JF Cr concentration (p < 0.001). Conclusion Elevations in CoCr JFRs are associated with adverse biological (severe ALVAL) or tribocorrosive processes (SOTP). Comparison of serum Cr with blood Cr concentrations may be a useful additional clinical tool to help to identify these conditions.Cite this article: D. J. Langton, S. Natu, C. F. Harrington, J. G. Bowsher, A. V. F. Nargol. Is the synovial fluid cobalt-to-chromium ratio related to the serum partitioning of metal debris following metal-on-metal hip arthroplasty? Bone Joint Res 2019;8:146-155. DOI: 10.1302/2046-3758.83.BJR-2018-0049.R1.
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Affiliation(s)
- D J Langton
- Northern Retrieval Registry, The Biosphere, Newcastle Helix, Newcastle upon Tyne, UK
| | - S Natu
- University Hospital of North Tees, Stockton-on-Tees, UK
| | - C F Harrington
- Supra-Regional Assay Service (SAS), Trace Element Centre, Guildford, UK
| | - J G Bowsher
- Food and Drugs Administration, Silver Spring, Maryland, USA
| | - A V F Nargol
- University Hospital of North Tees, Stockton-on-Tees, UK
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17
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Radice S, Holcomb T, Pourzal R, Hallab NJ, Laurent MP, Wimmer MA. Investigation of CoCrMo material loss in a novel bio-tribometer designed to study direct cell reaction to wear and corrosion products. ACTA ACUST UNITED AC 2019; 18. [PMID: 30984811 DOI: 10.1016/j.biotri.2019.100090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Wear and corrosion in total hip replacement negatively impact implant service-life and patient well-being. The aim of this study was to generate a statistical response surface of material loss using an apparatus, capable of testing the effect of wear and corrosion products in situ on cells, such as macrophages. The test chamber of a ball-on-flat tribometer operating inside a CO2 incubator was integrated with an electrochemical setup and adapted for cell culture work. A 20-test series, following a 2-level 3-factor design of experiments, was performed with a ceramic head in reciprocating rotational motion against a CoCrMo-alloy disc, under constant load. The lubricant was cell culture medium (RPMI-1640+10vol% bovine serum). Response surfaces were generated, which statistically showed the influence of motion amplitude, load, and potential on the total mass loss and wear scar volume of the metallic discs. Potential had the highest impact on the total mass loss, while motion amplitude and load significantly influenced the wear scar volume. The concentrations of the alloy elements found in the lubricants reflected the bulk-alloy stoichiometry. The total concentration of Co released into the lubricant (2.3-63 ppm by total mass loss, 1.5 to 62 ppm by ICP-MS) corresponded well with the known range to trigger cell response. Tribocorrosion tests in the presence of cells and tissues, such as macrophages, lymphocytes and/or synovium, will be carried out in the future.
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Affiliation(s)
- S Radice
- Department of Orthopedic Surgery, Rush UniversityMedical Center, Chicago, IL, USA
| | - T Holcomb
- Department of Orthopedic Surgery, Rush UniversityMedical Center, Chicago, IL, USA
| | - R Pourzal
- Department of Orthopedic Surgery, Rush UniversityMedical Center, Chicago, IL, USA
| | - N J Hallab
- Department of Orthopedic Surgery, Rush UniversityMedical Center, Chicago, IL, USA
| | - M P Laurent
- Department of Orthopedic Surgery, Rush UniversityMedical Center, Chicago, IL, USA
| | - M A Wimmer
- Department of Orthopedic Surgery, Rush UniversityMedical Center, Chicago, IL, USA
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18
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Cr(VI)‐induced genotoxicity and cell cycle arrest in human osteoblast cell line MG‐63. J Appl Toxicol 2019; 39:1057-1065. [DOI: 10.1002/jat.3793] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/25/2019] [Accepted: 02/07/2019] [Indexed: 11/07/2022]
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Munir KS, Wen C, Li Y. Carbon Nanotubes and Graphene as Nanoreinforcements in Metallic Biomaterials: a Review. ACTA ACUST UNITED AC 2019; 3:e1800212. [PMID: 32627403 DOI: 10.1002/adbi.201800212] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 01/22/2019] [Indexed: 12/13/2022]
Abstract
Current challenges in existing metallic biomaterials encourage undertaking research in the development of novel materials for biomedical applications. This paper critically reviews the potential of carbon nanotubes (CNT) and graphene as nanoreinforcements in metallic biomaterials for bone tissue engineering. Unique and remarkable mechanical, electrical, and biological properties of these carbon nanomaterials allow their use as secondary-phase reinforcements in monolithic biomaterials. The nanoscale dimensions and extraordinarily large surface areas of CNT and graphene make them suitable materials for purposeful reaction with living organisms. However, the cytocompatibility of CNT and graphene is still a controversial issue that impedes advances in utilizing these promising materials in clinical orthopedic applications. The interaction of CNT and graphene with biological systems including proteins, nucleic acids, and human cells is critically reviewed to assess their cytocompatibity in vitro and in vivo. It is revealed that composites reinforced with CNT and graphene show enhanced adhesion of osteoblast cells, which subsequently promotes bone tissue formation in vivo. This potential is expected to pave the way for developing ground-breaking technologies in regenerative medicine and bone tissue engineering. In addition, current progress and future research directions are highlighted for the development of CNT and graphene reinforced implants for bone tissue engineering.
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Affiliation(s)
- Khurram S Munir
- School of Engineering, RMIT University, Bundoora, Victoria, 3083, Australia
| | - Cuie Wen
- School of Engineering, RMIT University, Bundoora, Victoria, 3083, Australia
| | - Yuncang Li
- School of Engineering, RMIT University, Bundoora, Victoria, 3083, Australia
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20
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Mercuri LG, Miloro M, Skipor AK, Bijukumar D, Sukotjo C, Mathew MT. Serum Metal Levels in Maxillofacial Reconstructive Surgery Patients: A Pilot Study. J Oral Maxillofac Surg 2018; 76:2074-2080. [DOI: 10.1016/j.joms.2018.04.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/16/2018] [Accepted: 04/16/2018] [Indexed: 10/17/2022]
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21
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Lin TJ, Huang YL, Chang JS, Liu KT, Yen MC, Chen FW, Shih YL, Jao JC, Huang PC, Yeh IJ. Optimal dosage and early intervention of L-ascorbic acid inhibiting K 2Cr 2O 7-induced renal tubular cell damage. J Trace Elem Med Biol 2018; 48:1-7. [PMID: 29773167 DOI: 10.1016/j.jtemb.2018.02.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 02/02/2018] [Accepted: 02/23/2018] [Indexed: 01/12/2023]
Abstract
Chromium poisoning can cause renal failure and death. Chromium intoxication may be managed using L-ascorbic acid (vitamin C) therapy. However, the evidence supporting the effectiveness of this treatment is insufficient, and the mechanism of action has not been clarified in renal cells. In this study, our results showed that the optimal regimen of L-ascorbic acid therapy in human epithelial renal proximal tubule cells, HK-2 cells, was 30 μg/mL. Supplementation of L-ascorbic acid with 30 μg/mL and within 8 h of chromium intoxication (K2Cr2O7, Cr6+) was effective to inhibit renal tubular cell damage by blocking generation of free radicals, cell apoptosis, and autophagy. Intracellular chromium concentrations were estimated using electrothermal atomic absorption spectrometry. Treatment of L-ascorbic acid within 8 h of chromium intoxication significantly decreased the entry of chromium into the cells. Moreover, concomitant administration of L-ascorbic acid with repeatedly dosing at 8-hourly intervals had a better protective effect at lower concentration of L-ascorbic acid when compared to single dosing of L-ascorbic acid at an early time point of chromium intoxication. These findings might help physicians develop effective therapy strategies in renal failure.
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Affiliation(s)
- Tzeng-Jih Lin
- Emergency Department, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Family Medicine Department, Taoyuan Branch, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yeou-Lih Huang
- Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jung-San Chang
- Department of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuan-Ting Liu
- Emergency Department, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Meng-Chi Yen
- Emergency Department, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Fen-Wei Chen
- Emergency Department, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yueh-Lun Shih
- Emergency Department, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jo-Chi Jao
- Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Chi Huang
- Department of Pathology, Taipei City Hospital, Taipei, Taiwan
| | - I-Jeng Yeh
- Emergency Department, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
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22
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Bio-Corrosion Behavior of Ceramic Coatings Containing Hydroxyapatite on Mg-Zn-Ca Magnesium Alloy. APPLIED SCIENCES-BASEL 2018. [DOI: 10.3390/app8040569] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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23
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Swiatkowska I, Mosselmans JFW, Geraki T, Wyles CC, Maleszewski JJ, Henckel J, Sampson B, Potter DB, Osman I, Trousdale RT, Hart AJ. Synchrotron analysis of human organ tissue exposed to implant material. J Trace Elem Med Biol 2018; 46:128-137. [PMID: 29413102 DOI: 10.1016/j.jtemb.2017.12.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/19/2017] [Accepted: 12/21/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Orthopaedic implants made of cobalt-chromium alloy undergo wear and corrosion that can lead to deposition of cobalt and chromium in vital organs. Elevated cardiac tissue cobalt levels are associated with myocardial injury while chromium is a well-established genotoxin. Though metal composition of tissues surrounding hip implants has been established, few investigators attempted to characterize the metal deposits in systemic tissues of total joint arthroplasty patients. METHODS We report the first use of micro-X-ray fluorescence coupled with micro-X-ray absorption spectroscopy to probe distribution and chemical form of cobalt, chromium and titanium in postmortem samples of splenic, hepatic and cardiac tissue of patients with metal-on-polyethylene hip implants (n = 5). RESULTS Majority of the cobalt was in the 2+ oxidation state, while titanium was present exclusively as titanium dioxide, in either rutile or anatase crystal structure. Chromium was found in a range of forms including a highly oxidised, carcinogenic species (CrV/VI), which has never been identified in human tissue before. CONCLUSIONS Carcinogenic forms of chromium might arise in vital organs of total joint arthroplasty patients. Further studies are warranted with patients with metal-on-metal implants, which tend to have an increased release of cobalt and chromium compared to metal-on-polyethylene hips.
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Affiliation(s)
- Ilona Swiatkowska
- Institute of Orthopaedics and Musculoskeletal Science, University College London, HA7 4LP Stanmore, UK.
| | - J Fred W Mosselmans
- Diamond Light Source, Harwell Science and Innovation Campus, OX11 0DE Didcot, UK
| | - Tina Geraki
- Diamond Light Source, Harwell Science and Innovation Campus, OX11 0DE Didcot, UK
| | - Cody C Wyles
- Mayo Clinic, 200 1st Street SW, Rochester, MN, USA
| | | | - Johann Henckel
- Royal National Orthopaedic Hospital, HA7 4LP Stanmore, UK
| | - Barry Sampson
- Trace Element Laboratory, Department of Clinical Chemistry, Charing Cross Hospital, Imperial College NHS Healthcare Trust, W6 8RF London, UK
| | - Dominic B Potter
- Departament of Chemistry, University College London, WC1H 0AJ London, UK
| | - Ibtisam Osman
- Trace Element Laboratory, Department of Clinical Chemistry, Charing Cross Hospital, Imperial College NHS Healthcare Trust, W6 8RF London, UK
| | | | - Alister J Hart
- Institute of Orthopaedics and Musculoskeletal Science, University College London, HA7 4LP Stanmore, UK; Royal National Orthopaedic Hospital, HA7 4LP Stanmore, UK
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24
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Zvicer J, Obradovic B. Bioreactors with hydrostatic pressures imitating physiological environments in intervertebral discs. J Tissue Eng Regen Med 2017; 12:529-545. [PMID: 28763577 DOI: 10.1002/term.2533] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 06/27/2017] [Accepted: 07/27/2017] [Indexed: 12/28/2022]
Abstract
Intervertebral discs are normally exposed to a variety of loads and stresses but hydrostatic pressure (HP) could be the main biosignal for chondrogenic cell differentiation and maintenance of this tissue. Although there are simple approaches to intermittently expose cell cultures to HP in separate material testing devices, utilization of biomimetic bioreactors aiming to provide in vitro conditions mimicking those found in vivo, attracts special attention. However, design of such bioreactors is complex due to the requirement of high HP magnitudes (up to 3 MPa) applied in different regimes mimicking pressures arising in intervertebral disc during normal daily activities. Furthermore, efficient mass transfer has to be facilitated to cells within 3D scaffolds, and the engineering challenges include avoidance or removal of gas bubbles in the culture medium before pressurization as well as selection of appropriate, biocompatible construction materials and maintenance of sterility during cultivation. Here, we review approaches to induce HP in 2D and 3D cell cultures categorized into 5 groups: (I) discontinuous systems with direct pressurization of the cultivation medium by a piston, (II) discontinuous systems with indirect pressurization by a compression fluid, (III) continuous systems with direct pressurization of the cultivation medium, static culture, (IV) continuous systems with culture perfusion, and (V) systems applying HP in conjunction with other physical signals. Although the complexity is increasing as additional features are added to the systems, the need to understand HP effects on cells and tissues in a physiologically relevant, yet precisely controlled, environment together with current technological advancements are leading towards innovative bioreactor solutions.
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Affiliation(s)
- Jovana Zvicer
- Faculty of Technology and Metallurgy, University of Belgrade, Belgrade, Serbia
| | - Bojana Obradovic
- Faculty of Technology and Metallurgy, University of Belgrade, Belgrade, Serbia
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25
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Vierra BM, Blumenthal SR, Amanatullah DF. Modularity in Total Hip Arthroplasty: Benefits, Risks, Mechanisms, Diagnosis, and Management. Orthopedics 2017; 40:355-366. [PMID: 28598491 DOI: 10.3928/01477447-20170606-01] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 11/07/2016] [Indexed: 02/03/2023]
Abstract
Modular implants are currently widely used in total hip arthroplasty because they give surgeons versatility during the operation, allow for easier revision surgery, and can be adjusted to better fit the anatomy of the specific patient. However, modular implants, specifically those that have metal-on-metal junctions, are susceptible to crevice and fretting corrosion. This can ultimately cause implant failure, inflammation, and adverse local tissue reaction, among other possible side effects. Surgeons should be aware of the possibility of implant corrosion and should follow a set of recommended guidelines to systematically diagnose and treat patients with corroded implants. Ultimately, surgeons will continue to use modular implants because of their widespread benefits. However, more research is needed to determine how to minimize corrosion and the negative side effects that have been associated with modular junctions in total hip arthroplasty. [Orthopedics. 2017; 40(6):355-366.].
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26
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Ray RR. Adverse hematological effects of hexavalent chromium: an overview. Interdiscip Toxicol 2017; 9:55-65. [PMID: 28652847 PMCID: PMC5458105 DOI: 10.1515/intox-2016-0007] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 12/10/2015] [Accepted: 01/17/2016] [Indexed: 01/09/2023] Open
Abstract
Workers of tanneries, welding industries, factories manufacturing chromate containing paints are exposed to hexavalent chromium that increases the risk of developing serious adverse health effects. This review elucidates the mode of action of hexavalent chromium on blood and its adverse effects. Both leukocyte and erythrocyte counts of blood sharply decreased in Swiss mice after two weeks of intraperitoneal treatment with Cr (VI), with the erythrocytes transforming into echinocytes. The hexavalent chromium in the blood is readily reduced to trivalent form and the reductive capacity of erythrocytes is much greater than that of plasma. Excess Cr (VI), not reduced in plasma, may enter erythrocytes and lymphocytes and in rodents it induces microcytic anemia. The toxic effects of chromium (VI) include mitochondrial injury and DNA damage of blood cells that leads to carcinogenicity. Excess Cr (VI) increases cytosolic Ca2+ activity and ATP depletion thereby inducing eryptosis. Se, vitamin C, and quercetin are assumed to have some protective effect against hexavalent chromium induced hematological disorders.
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Affiliation(s)
- Rina Rani Ray
- Postgraduate Department of Zoology, Bethune College, 181, Bidhan Sarani, Kolkata: 700 006, India
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Moniz S, Hodgkinson S, Yates P. Cardiac transplant due to metal toxicity associated with hip arthroplasty. Arthroplast Today 2017; 3:151-153. [PMID: 28913397 PMCID: PMC5585818 DOI: 10.1016/j.artd.2017.01.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 01/28/2017] [Accepted: 01/31/2017] [Indexed: 12/12/2022] Open
Abstract
Concerns regarding metal-on-metal (MoM) bearing couples in total hip arthroplasty are well documented in the literature with cobalt (Co) and chromium (Cr) toxicity causing a range of both local and systemic adverse reactions. We describe the case of a patient undergoing cardiac transplantation as a direct result of Co and Cr toxicity following a MoM hip replacement. Poor implant positioning led to catastrophic wear generating abundant wear particles leading to Co and Cr toxicity, metallosis, bony destruction, elevated metal ion levels, and adverse biological responses. Systemic symptoms continued for 3 years following cardiac transplantation with resolution only after revision hip arthroplasty. There was no realization in the initial cardiac assessment and subsequent transplant workup that the hip replacement was the likely cause of the cardiac failure, and the hip replacement was not recognized as the cause until years after the heart transplant. This case highlights the need for clinicians to be aware of systemic MoM complications as well as the importance of positioning when using these prostheses.
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Affiliation(s)
- Sheldon Moniz
- Corresponding author. 8 Green Vale Heights, Leeming, Perth, WA 6149, Australia. Tel.: +6 143 382 8016.8 Green Vale HeightsLeemingPerthWA6149Australia
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Release of metal ions from nano CoCrMo wear debris generated from tribo-corrosion processes in artificial hip implants. J Mech Behav Biomed Mater 2017; 68:124-133. [PMID: 28161662 DOI: 10.1016/j.jmbbm.2017.01.041] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 12/12/2016] [Accepted: 01/25/2017] [Indexed: 12/27/2022]
Abstract
CoCrMo alloys have been widely used in metal-on-metal (MoM) hip replacements due to their superior wear and corrosion resistance properties. However, metal ions like Co2+ and Cr3+, or even Cr6+ released from CoCrMo hip prostheses can induce macrophage apoptotic vs. necrotic mortality and damage the surrounding tissues. Simultaneously, osteolysis induced by the wear debris can be a cause of failure. Nano wear debris is more active than the bulk material, due to its small size. In this study, to accurately analyse the fresh wear debris retrieved from the hip simulator and the interaction between the particles and tribocorrosion of CoCrMo, wear debris was observed without protein digest, using a combined experimental approach involving the employment of TEM and ICP-MS. The results suggest that nanoscale wear debris generated from a hip simulator in bovine serum albumin (BSA) lubrication was Cr-rich, containing crystalline and amorphous structures; meanwhile, without any proteins, the wear particles mostly had an hcp-Co crystalline structure.
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Saleh MM, Touny AH, Al-Omair MA, Saleh MM. Biodegradable/biocompatible coated metal implants for orthopedic applications. Biomed Mater Eng 2017; 27:87-99. [PMID: 27175470 DOI: 10.3233/bme-161568] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Biocompatible metals have been suggested as revolutionary biomaterials for bone-grafting therapies. Although metals and their alloys are widely and successfully used in producing biomedical implants due to their good mechanical properties and corrosion resistance, they have a lack in bioactivity. Therefore coating of the metal surface with calcium phosphates (CaP) is a benign way to achieve well bioactivity and get controlled corrosion properties. The biocompatibility and bioactivity calcium phosphates (CaP) in bone growth were guided them to biomedical treatment of bone defects and fractures. Many techniques have been used for fabrication of CaP coatings on metal substrates such as magnesium and titanium. The present review will focus on the synthesis of CaP and their relative forms using different techniques especially electrochemical techniques. The latter has always been known of its unique way of optimizing the process parameters that led to a control in the structure and characteristics of the produced materials.
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Affiliation(s)
- Mohamed M Saleh
- Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - A H Touny
- Department of Chemistry, Faculty of Science, Helwan University, Helwan, Cairo, Egypt.,Chemistry Department, College of Science, King Faisal University, Al-Hassa, Saudi Arabia
| | - Mohammed A Al-Omair
- Chemistry Department, College of Science, King Faisal University, Al-Hassa, Saudi Arabia
| | - M M Saleh
- Department of Chemistry, Faculty of Science, Cairo University, Cairo, Egypt.,Chemistry Department, College of Science, King Faisal University, Al-Hassa, Saudi Arabia
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30
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Gibon E, Amanatullah DF, Loi F, Pajarinen J, Nabeshima A, Yao Z, Hamadouche M, Goodman SB. The biological response to orthopaedic implants for joint replacement: Part I: Metals. J Biomed Mater Res B Appl Biomater 2016; 105:2162-2173. [PMID: 27328111 DOI: 10.1002/jbm.b.33734] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 04/19/2016] [Accepted: 06/01/2016] [Indexed: 12/12/2022]
Abstract
Joint replacement is a commonly performed, highly successful orthopaedic procedure, for which surgeons have a large choice of different materials and implant designs. The materials used for joint replacement must be both biologically acceptable to minimize adverse local tissue reactions, and robust enough to support weight bearing during common activities of daily living. Modern joint replacements are made from metals and their alloys, polymers, ceramics, and composites. This review focuses on the biological response to the different biomaterials used for joint replacement. In general, modern materials for joint replacement are well tolerated by the body as long as they are in bulk (rather than in particulate or ionic) form, are mechanically stable and noninfected. If the latter conditions are not met, the prosthesis will be associated with an acute/chronic inflammatory reaction, peri-prosthetic osteolysis, loosening and failure. This article (Part 1 of 2) is dedicated to the use of metallic devices in orthopaedic surgery including the associated biological response to metallic byproducts is a review of the basic science literature regarding this topic. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2162-2173, 2017.
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Affiliation(s)
- Emmanuel Gibon
- Department of Orthopaedic Surgery, Stanford University, Stanford, California.,Laboratoire de Biomécanique et Biomatériaux Ostéo-Articulaires - UMR CNRS 7052, Faculté de Médecine - Université Paris7, Paris, France.,Department of Orthopaedic Surgery, Hopital Cochin, APHP, Université Paris5, Paris, France
| | - Derek F Amanatullah
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Florence Loi
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Jukka Pajarinen
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Akira Nabeshima
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Zhenyu Yao
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Moussa Hamadouche
- Department of Orthopaedic Surgery, Hopital Cochin, APHP, Université Paris5, Paris, France
| | - Stuart B Goodman
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
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31
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Vasconcelos DM, Santos SG, Lamghari M, Barbosa MA. The two faces of metal ions: From implants rejection to tissue repair/regeneration. Biomaterials 2016; 84:262-275. [DOI: 10.1016/j.biomaterials.2016.01.046] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 01/20/2016] [Accepted: 01/21/2016] [Indexed: 12/20/2022]
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32
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Metal release from stainless steel in biological environments: A review. Biointerphases 2016; 11:018901. [DOI: 10.1116/1.4934628] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Mendes MBM, Medeiros RCD, Lauria A, Marchiori É, Sawazaki R, Lopes ÉSN, Moreira RWF. Mechanical and microstructural properties of fixation systems used in oral and maxillofacial surgery. Oral Maxillofac Surg 2015; 20:85-90. [PMID: 26563099 DOI: 10.1007/s10006-015-0532-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 10/30/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This paper aims to evaluate in vitro the mechanical and microstructural properties of internal fixation systems used in oral and maxillofacial surgeries. MATERIALS AND METHODS Four brands of internal fixation systems (screws and 4-hole straight plates) were selected and assigned to four groups: G1 Leibinger®, G2 Tóride®, G3 Engimplan®, and G4 Medartis®. The systems were submitted to Vickers hardness testing, metallographic and interstitial elements chemical composition analyses. Data were submitted to ANOVA and Tukey's test for statistical analysis. RESULTS Plates in groups 1, 2, and 3 showed similar microstructure and mechanical properties, different from those in G4 revealing larger grains. In all groups, the screws showed similar microstructure, with uniform arrangement and size of grains; the screws showed higher hardness values than those observed for the plates. CONCLUSIONS The results indicate that all materials tested are adequate for use in oral maxillofacial surgeries.
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Affiliation(s)
- Marcelo Breno Meneses Mendes
- Department of Oral Diagnosis, Oral and Maxillofacial Surgery Division, Piracicaba Dental School CP 52, State University of Campinas-UNICAMP, 13.414-903, Piracicaba, SP, Brazil.
| | - Raquel Correia de Medeiros
- Department of Oral Diagnosis, Oral and Maxillofacial Surgery Division, Piracicaba Dental School CP 52, State University of Campinas-UNICAMP, 13.414-903, Piracicaba, SP, Brazil
| | - Andrezza Lauria
- Department of Oral Diagnosis, Oral and Maxillofacial Surgery Division, Piracicaba Dental School CP 52, State University of Campinas-UNICAMP, 13.414-903, Piracicaba, SP, Brazil
| | - Érica Marchiori
- Department of Oral Diagnosis, Oral and Maxillofacial Surgery Division, Piracicaba Dental School CP 52, State University of Campinas-UNICAMP, 13.414-903, Piracicaba, SP, Brazil
| | - Renato Sawazaki
- Temporary Substitute Professor of Oral and Maxillofacial Surgery, University of Passo Fundo, Rio Grande do Sul, Brazil
| | - Éder Sócrates Najar Lopes
- Department of Manufacturing and Materials Engineering, State University of Campinas-UNICAMP, CP 6122, 13.083-970, Campinas, SP, Brazil
| | - Roger William Fernandes Moreira
- Department of Oral Diagnosis, Oral and Maxillofacial Surgery Division, Piracicaba Dental School CP 52, State University of Campinas-UNICAMP, 13.414-903, Piracicaba, SP, Brazil
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Hedberg YS, Pettersson M, Pradhan S, Odnevall Wallinder I, Rutland M, Persson C. Can Cobalt(II) and Chromium(III) Ions Released from Joint Prostheses Influence the Friction Coefficient? ACS Biomater Sci Eng 2015; 1:617-620. [DOI: 10.1021/acsbiomaterials.5b00183] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Y. S. Hedberg
- Division
of Surface and Corrosion Science, Department of Chemistry, School
of Chemical Science and Engineering, KTH Royal Institute of Technology, Drottning Kristinas väg 51, SE-10044 Stockholm, Sweden
- Unit
of Occupational and Environmental Dermatology, Institute of Environmental
Medicine, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - M. Pettersson
- Division
of Applied Materials Science, Department of Engineering Sciences, Uppsala University, 75121 Uppsala, Sweden
| | - S. Pradhan
- Division
of Surface and Corrosion Science, Department of Chemistry, School
of Chemical Science and Engineering, KTH Royal Institute of Technology, Drottning Kristinas väg 51, SE-10044 Stockholm, Sweden
| | - I. Odnevall Wallinder
- Division
of Surface and Corrosion Science, Department of Chemistry, School
of Chemical Science and Engineering, KTH Royal Institute of Technology, Drottning Kristinas väg 51, SE-10044 Stockholm, Sweden
| | - M.W. Rutland
- Division
of Surface and Corrosion Science, Department of Chemistry, School
of Chemical Science and Engineering, KTH Royal Institute of Technology, Drottning Kristinas väg 51, SE-10044 Stockholm, Sweden
- Chemistry,
Materials and Surfaces, SP Technical Research Institute of Sweden, SE-114
86 Stockholm, Sweden
| | - C. Persson
- Division
of Applied Materials Science, Department of Engineering Sciences, Uppsala University, 75121 Uppsala, Sweden
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35
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In Vitro Analyses of the Toxicity, Immunological, and Gene Expression Effects of Cobalt-Chromium Alloy Wear Debris and Co Ions Derived from Metal-on-Metal Hip Implants. LUBRICANTS 2015. [DOI: 10.3390/lubricants3030539] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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36
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Toxicology of wear particles of cobalt-chromium alloy metal-on-metal hip implants Part I: Physicochemical properties in patient and simulator studies. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2015; 11:1201-15. [DOI: 10.1016/j.nano.2014.12.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 11/19/2014] [Accepted: 12/03/2014] [Indexed: 12/27/2022]
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37
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Cadossi M, Mazzotti A, Baldini N, Giannini S, Savarino L. New couplings, old problems: Is there a role for ceramic-on-metal hip arthroplasty? J Biomed Mater Res B Appl Biomater 2015; 104:204-9. [DOI: 10.1002/jbm.b.33383] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 12/11/2014] [Accepted: 01/22/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Matteo Cadossi
- Department I of Orthopaedics and Traumatology; Rizzoli Orthopaedic Institute; Bologna Italy
- Department of Biomedical and Neuromotor Sciences; Bologna University; Bologna Italy
| | - Antonio Mazzotti
- Department of Biomedical and Neuromotor Sciences; Bologna University; Bologna Italy
| | - Nicola Baldini
- Department of Biomedical and Neuromotor Sciences; Bologna University; Bologna Italy
- Laboratory for Orthopaedic Pathophysiology and Regenerative Medicine; Rizzoli Orthopaedic Institute; Bologna Italy
| | - Sandro Giannini
- Department I of Orthopaedics and Traumatology; Rizzoli Orthopaedic Institute; Bologna Italy
- Department of Biomedical and Neuromotor Sciences; Bologna University; Bologna Italy
| | - Lucia Savarino
- Laboratory for Orthopaedic Pathophysiology and Regenerative Medicine; Rizzoli Orthopaedic Institute; Bologna Italy
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Gopi D, Murugan N, Ramya S, Shinyjoy E, Kavitha L. Ball flower like manganese, strontium substituted hydroxyapatite/cerium oxide dual coatings on the AZ91 Mg alloy with improved bioactive and corrosion resistance properties for implant applications. RSC Adv 2015. [DOI: 10.1039/c5ra03432a] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Mn, Sr-HAP/CeO2dual layer coated AZ91 Mg alloy will be a revolutionary potential material for orthopedic implants.
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Affiliation(s)
- D. Gopi
- Department of Chemistry
- Periyar University
- Salem 636 011
- India
- Centre for Nanoscience and Nanotechnology
| | - N. Murugan
- Department of Chemistry
- Periyar University
- Salem 636 011
- India
| | - S. Ramya
- Department of Chemistry
- Periyar University
- Salem 636 011
- India
| | - E. Shinyjoy
- Department of Chemistry
- Periyar University
- Salem 636 011
- India
| | - L. Kavitha
- Department of Physics
- School of Basic and Applied Sciences
- Central University of Tamilnadu
- Thiruvarur 610 101
- India
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Abstract
INTRODUCTION One in eight of all total hip replacements requires revision within 10 years, 60% because of wear-related complications. The bearing surfaces may be made of cobalt/chromium, stainless steel, ceramic, or polyethylene. Friction between bearing surfaces and corrosion of non-moving parts can result in increased local and systemic metal concentrations. OBJECTIVES To identify and systematically review published reports of systemic toxicity attributed to metal released from hip implants and to propose criteria for the assessment of these patients. METHODS Medline (from 1950) and Embase (from 1980) were searched to 28 February 2014 using the search terms (text/abstract) chrom* or cobalt* and [toxic* or intox* or poison* or adverse effect or complication] and [prosthes* or 'joint replacement' or hip or arthroplast*] and PubMed (all available years) was searched using the search term (("Chromium/adverse effects"[Mesh] OR "Chromium/poisoning"[Mesh] OR "Chromium/toxicity"[Mesh]) OR ("Cobalt/adverse effects"[Mesh] OR "Cobalt/poisoning"[Mesh] OR "Cobalt/toxicity"[Mesh])) AND ("Arthroplasty, Replacement, Hip"[Mesh] OR "Hip Prosthesis"[Mesh]). These searches identified 281 unique references, of which 23 contained original case data. Three further reports were identified from the bibliographies of these papers. As some cases were reported repeatedly the 26 papers described only 18 individual cases. Systemic toxicity. Ten of these eighteen patients had undergone revision from a ceramic-containing bearing to one containing a metal component. The other eight had metal-on-metal prostheses. Systemic toxicity was first manifest months and often several years after placement of the metal-containing joint. The reported systemic features fell into three main categories: neuro-ocular toxicity (14 patients), cardiotoxicity (11 patients) and thyroid toxicity (9 patients). Neurotoxicity was manifest as peripheral neuropathy (8 cases), sensorineural hearing loss (7) and cognitive decline (5); ocular toxicity presented as visual impairment (6). All these neurological features, except cognitive decline, have been associated with cobalt poisoning previously. Type of prosthesis and blood metal concentrations. Where blood or serum metal concentrations were reported (n = 17 for cobalt and n = 14 for chromium), the median cobalt concentration was 398 (range, 13.6-6521) μg/L and the median chromium concentration was 48 μg/L (in whole blood) (range, 4.1-221 μg/L including serum and blood values). Those patients reported to have systemic features who had received a metal-on-metal prosthesis (n = 8) had a median peak blood cobalt concentration of 34.5 (range, 13.6-398.6) μg/L; those with a metal-containing revision of a failed ceramic prosthesis (n = 10) had a median blood cobalt concentration of 506 (range, 353-6521) μg/L. Management. The most common treatment was removal of the metal-containing prosthesis, undertaken in all but 2 patients. This was usually associated with a fall in circulating cobalt concentration and improvement in some or all features. Clinical and toxicological assessment of systemic features. We propose the following criteria for assessing the likelihood that clinical features are related to cobalt toxicity: clinical effects consistent with the known neurological, cardiac, or thyroidal effects of cobalt, and for which any other explanation is less likely; increased blood cobalt concentrations (substantially higher than those in patients with well-functioning prostheses) several months after hip replacement; a fall in the blood cobalt concentration, usually accompanied by signs of improvement in features. When judged by these criteria, the systemic features in 10 of the reported cases are likely to be related to cobalt exposure from a metal-containing hip prosthesis. CONCLUSIONS Rarely, patients exposed to high circulating concentrations of cobalt from failed hip replacements develop neurological damage, hypothyroidism and/or cardiomyopathy, which may not resolve completely even after removal of the prosthesis. The greatest risk of systemic cobalt toxicity seems to result from accelerated wear of a cobalt-containing revision of a failed ceramic prosthesis, rather than from primary failure of a metal-on-metal prosthesis.
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Affiliation(s)
- S M Bradberry
- West Midlands Poisons Unit, City Hospital , Birmingham , UK
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40
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Abstract
Chromium is ubiquitous in the environment as Cr(III) and Cr(VI) oxidation states, which interconvert under environmentally and biologically relevant conditions (although Cr(III) usually predominates). While Cr(VI) is an established human carcinogen and a major occupational and environmental hazard, Cr(III) has long been regarded as an essential human micronutrient, although recent literature has cast serious doubts on the validity of this postulate. Despite five decades of research, no functional Cr-containing enzymes or cofactors have been characterized conclusively, and several hypotheses on their possible structures have been refuted. Gastrointestinal absorption pathways for both Cr(III) and Cr(VI) are apparent and whole-blood speciation can involve Cr(VI) uptake and reduction by red blood cells, as well as Cr(III) binding to both proteins and low-molecular-mass ligands in the plasma. DNA-damaging effects of Cr(VI) and anti-diabetic activities of Cr(III) are likely to arise from common mechanistic pathways that involve reactive Cr(VI/V/IV) intermediates and kinetically inert Cr(III)-protein and Cr(III)-DNA adducts. Both Cr(III) and Cr(VI) are toxic to plants and microorganisms, particularly Cr(VI) due to its higher bioavailability and redox chemistry. Some bacteria reduce Cr(VI) to Cr(III) without the formation of toxic Cr(V) intermediates and these bacteria are being considered for use in the bioremediation of Cr(VI)-polluted environments.
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Affiliation(s)
- Peter A. Lay
- School of Chemistry, The University of Sydney Sydney NSW 2006 Australia
| | - Aviva Levina
- School of Chemistry, The University of Sydney Sydney NSW 2006 Australia
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41
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Molecular analysis of chromium and cobalt-related toxicity. Sci Rep 2014; 4:5729. [PMID: 25034144 PMCID: PMC4103093 DOI: 10.1038/srep05729] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 06/27/2014] [Indexed: 12/12/2022] Open
Abstract
Occupational and environmental exposure to Co and Cr has been previously linked to a wide array of inflammatory and degenerative conditions and cancer. Recently, significant health concerns have been raised by the high levels of Cr and Co ions and corrosion products released by biomedical implants. Herein, we set to analyze the biological responses associated with Co and Cr toxicity. Histological, ultrastructural, and elemental analysis, performed on Cr and Co exposed patients reveal the presence of corrosion products, metallic wear debris and metal ions at varying concentrations. Metallic ions and corrosion products were also generated in vitro following macrophage phagocytosis of metal alloys. Ex vivo redox proteomic mapped several oxidatively damaged proteins by Cr(III) and Co(II)-induced Fenton reaction. Importantly, a positive correlation between the tissue amounts of Cr(III) and Co(II) ions and tissue oxidative damage was observed. Immobilized- Cr(III) and Co(II) affinity chromatography indicated that metal ions can also directly bind to several metallo and non-metalloproteins and, as demonstrated for aldolase and catalase, induce loss of their biological function. Altogether, our analysis reveals several biological mechanisms leading to tissue damage, necrosis, and inflammation in patients with Cr and Co-associated adverse local tissue reactions.
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Matusiewicz H. Potential release of in vivo trace metals from metallic medical implants in the human body: from ions to nanoparticles--a systematic analytical review. Acta Biomater 2014; 10:2379-403. [PMID: 24565531 DOI: 10.1016/j.actbio.2014.02.027] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 12/04/2013] [Accepted: 02/13/2014] [Indexed: 02/06/2023]
Abstract
Metal ion release from metallic materials, e.g. metallic alloys and pure metals, implanted into the human body in dental and orthopedic surgery is becoming a major cause for concern. This review briefly provides an overview of both metallic alloys and pure metals used in implant materials in dental and orthopedic surgery. Additionally, a short section is dedicated to important biomaterials and their corrosive behavior in both real solutions and various types of media that model human biological fluids and tissues. The present review gives an overview of analytical methods, techniques and different approaches applied to the measurement of in vivo trace metals released into body fluids and tissues from patients carrying metal-on-metal prostheses and metal dental implants. Reference levels of ion concentrations in body fluids and tissues that have been determined by a host of studies are compiled, reviewed and presented in this paper. Finally, a collection of published clinical data on in vivo released trace metals from metallic medical implants is included.
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Hadzima B, Mhaede M, Pastorek F. Electrochemical characteristics of calcium-phosphatized AZ31 magnesium alloy in 0.9 % NaCl solution. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2014; 25:1227-1237. [PMID: 24477876 DOI: 10.1007/s10856-014-5161-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 01/21/2014] [Indexed: 06/03/2023]
Abstract
Magnesium alloys suffer from their high reactivity in common environments. Protective layers are widely created on the surface of magnesium alloys to improve their corrosion resistance. This article evaluates the influence of a calcium-phosphate layer on the electrochemical characteristics of AZ31 magnesium alloy in 0.9 % NaCl solution. The calcium phosphate (CaP) layer was electrochemically deposited in a solution containing 0.1 M Ca(NO3)2, 0.06 M NH4H2PO4 and 10 ml l(-1) of H2O2. The formed surface layer was composed mainly of brushite [(dicalcium phosphate dihidrate (DCPD)] as proved by energy-dispersive X-ray analysis. The surface morphology was observed by scanning electron microscopy. Immersion test was performed in order to observe degradation of the calcium phosphatized surfaces. The influence of the phosphate layer on the electrochemical characteristics of AZ31, in 0.9 % NaCl solution, was evaluated by potentiodynamic measurements and electrochemical impedance spectroscopy. The obtained results were analysed by the Tafel-extrapolation method and equivalent circuits method. The results showed that the polarization resistance of the DCPD-coated surface is about 25 times higher than that of non-coated surface. The CaP electro-deposition process increased the activation energy of corrosion process.
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Affiliation(s)
- Branislav Hadzima
- Department of Materials Engineering, Faculty of Mechanical Engineering, University of Žilina, Univerzitná 1, 010 26, Zilina, Slovak Republic
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44
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Moroni A, Cadossi M, Bellenghi C, Romagnoli M, Bevoni R, Giannini S. Resurrection of hip resurfacing: what is the evidence? Expert Rev Med Devices 2014; 3:755-62. [PMID: 17280540 DOI: 10.1586/17434440.3.6.755] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Total hip resurfacing has long been conceptually attractive to both surgeons and patients. However, historically it has been plagued by limited durability and marked acetabular bone loss. The recent development of wear-resistant bearings, such as metal-on-metal, has led to renewed interest in hip resurfacing in the orthopedic community. Several resurfacing implants have been designed and positive results, particularly in young patients, have been reported. Although comparative studies of hip resurfacing and standard total hip replacement are still lacking, we believe that there is now evidence to demonstrate that this surgical concept deserves consideration, particularly when treating young patients with hip diseases.
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Affiliation(s)
- Antonio Moroni
- Bologna University, Rizzoli Orthopaedic Institute, Bologna, Istituti Ortopedici Rizzoli, Via G C Pupilli 1, 40136 Bologna, Italy.
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Hedberg Y, Odnevall Wallinder I. Metal release and speciation of released chromium from a biomedical CoCrMo alloy into simulated physiologically relevant solutions. J Biomed Mater Res B Appl Biomater 2013; 102:693-9. [DOI: 10.1002/jbm.b.33048] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 06/03/2013] [Accepted: 09/10/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Yolanda Hedberg
- KTH Royal Institute of Technology; School of Chemical Science and Engineering, Department of Chemistry, Division of Surface and Corrosion Science; Stockholm Sweden
| | - Inger Odnevall Wallinder
- KTH Royal Institute of Technology; School of Chemical Science and Engineering, Department of Chemistry, Division of Surface and Corrosion Science; Stockholm Sweden
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Acevedo D, Loy BN, Lee B, Omid R, Itamura J. Mixing implants of differing metallic composition in the treatment of upper-extremity fractures. Orthopedics 2013; 36:e1175-9. [PMID: 24025010 DOI: 10.3928/01477447-20130821-21] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Mixing implants with differing metallic compositions has been avoided for fear of galvanic corrosion and subsequent failure of the implants and of bone healing. The purpose of this study was to evaluate upper-extremity fractures treated with open reduction and internal fixation with metallic implants that differed in metallic composition placed on the same bone. The authors studied the effects of using both stainless steel and titanium implants on fracture healing, implant failure, and other complications associated with this method of fixation. Their hypothesis was that combining these metals on the same bone would not cause clinically significant nonunions or undo clinical effects from galvanic corrosion. A retrospective review was performed of 17 patients with upper-extremity fractures fixed with metal implants of differing metallic compositions. The primary endpoint was fracture union. Eight clavicles, 2 proximal humeri, 3 distal humeri, 3 olecranons, and 1 glenoid fracture with an average follow-up 10 months were reviewed. All fractures healed. One patient experienced screw backout, which did not affect healing. This study implies that mixing implants with differing metallic compositions on the same bone for the treatment of fractures does not adversely affect bone healing. No evidence existed of corrosion or an increase in complications with this method of treatment. Contrary to prior belief, small modular hand stainless steel plates can be used to assist in reduction of smaller fracture fragments in combination with anatomic titanium plates to obtain anatomic reduction of the fracture without adversely affecting healing.
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Sidaginamale RP, Joyce TJ, Lord JK, Jefferson R, Blain PG, Nargol AVF, Langton DJ. Blood metal ion testing is an effectivescreening tool to identify poorly performing metal-on-metal bearingsurfaces. Bone Joint Res 2013; 2:84-95. [PMID: 23836464 PMCID: PMC3670540 DOI: 10.1302/2046-3758.25.2000148] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objectives The aims of this piece of work were to: 1) record the background
concentrations of blood chromium (Cr) and cobalt (Co) concentrations
in a large group of subjects; 2) to compare blood/serum Cr and Co
concentrations with retrieved metal-on-metal (MoM) hip resurfacings;
3) to examine the distribution of Co and Cr in the serum and whole
blood of patients with MoM hip arthroplasties; and 4) to further
understand the partitioning of metal ions between the serum and
whole blood fractions. Methods A total of 3042 blood samples donated to the local transfusion
centre were analysed to record Co and Cr concentrations. Also, 91
hip resurfacing devices from patients who had given pre-revision
blood/serum samples for metal ion analysis underwent volumetric
wear assessment using a coordinate measuring machine. Linear regression analysis
was carried out and receiver operating characteristic curves were
constructed to assess the reliability of metal ions to identify
abnormally wearing implants. The relationship between serum and
whole blood concentrations of Cr and Co in 1048 patients was analysed
using Bland-Altman charts. This relationship was further investigated
in an in vitro study during which human blood was
spiked with trivalent and hexavalent Cr, the serum then separated
and the fractions analysed. Results Only one patient in the transfusion group was found to have a
blood Co > 2 µg/l. Blood/Serum Cr and Co concentrations were reliable
indicators of abnormal wear. Blood Co appeared to be the most useful
clinical test, with a concentration of 4.5 µg/l showing sensitivity
and specificity for the detection of abnormal wear of 94% and 95%, respectively.
Generated metal ions tended to fill the serum compartment preferentially in
vivo and this was replicated in the in vitro study
when blood was spiked with trivalent Cr and bivalent Co. Conclusions Blood/serum metal ion concentrations are reliable indicators
of abnormal wear processes. Important differences exist however
between elements and the blood fraction under study. Future guidelines
must take these differences into account.
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Affiliation(s)
- R P Sidaginamale
- Newcastle University, StephensonBuilding, Claremont Road, Newcastleupon Tyne NE1 7RU, UK
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Hedberg Y, Mazinanian N, Odnevall Wallinder I. Metal release from stainless steel powders and massive sheets--comparison and implication for risk assessment of alloys. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2013; 15:381-392. [PMID: 25208703 DOI: 10.1039/c2em30818e] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Industries that place metal and alloy products on the market are required to demonstrate that they are safe for all intended uses, and that any risks to humans, animals or the environment are adequately controlled. This requires reliable and robust in vitro test procedures. The aim of this study is to compare the release of alloy constituents from stainless steel powders of different grades (focus on AISI 316L) and production routes into synthetic body fluids with the release of the same metals from massive sheets in relation to material and surface characteristics. The comparison is justified by the fact that the difference between massive surfaces and powders from a metal release/dissolution and surface perspective is not clearly elucidated within current legislations. Powders and abraded and aged (24 h) massive sheets were exposed to synthetic solutions of relevance for biological settings and human exposure routes, for periods of up to one week. Concentrations of released iron, chromium, nickel, and manganese in solution were measured, and the effect of solution pH, acidity, complexation capacity, and proteins elucidated in relation to surface oxide composition and its properties. Implications for risk assessments based on in vitro metal release data from alloys are elucidated.
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Affiliation(s)
- Yolanda Hedberg
- KTH Royal Institute of Technology, Div. Surface and Corrosion Science, Dept. Chemistry, Drottning Kristinas väg 51, SE-10044 Stockholm, Sweden.
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Newton AW, Ranganath L, Armstrong C, Peter V, Roberts NB. Differential distribution of cobalt, chromium, and nickel between whole blood, plasma and urine in patients after metal-on-metal (MoM) hip arthroplasty. J Orthop Res 2012; 30:1640-6. [PMID: 22447496 DOI: 10.1002/jor.22107] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 03/01/2012] [Indexed: 02/04/2023]
Abstract
Evidence shows that raised cobalt (Co), chromium (Cr), and nickel (Ni) whole blood concentrations correlate with poor device outcome in patients following metal-on-metal (MoM) hip arthroplasty. To understand the local and systemic pathological effects of these raised metal concentrations it is important to define their distribution between whole blood, plasma, and urine. The metals were measured by Inductively Coupled Plasma Mass Spectrometry (ICPMS). Two hundred and five plasma, 199 whole blood, and 24 sets of urine samples were analyzed from 202 patients with Co-Cr alloy MoM hip prostheses implanted between 8 months to 12 years (mean 6.0 years) prior to analysis. Plasma Co (median 39.1 nmol/L) showed significantly positive 1:1 correlation with whole blood Co (median 45.9 nmol/L; R(2) = 0.98, p < 0.001, slope = 1.0). Plasma Cr (median 53.8 nmol/L) and whole blood Cr (median 40.3 nmol/L) were also correlated; however, concentrations were significantly higher in plasma indicating relatively little blood cell uptake (R(2) = 0.96, p < 0.001, slope = 1.6). Urinary Co was up to threefold higher than Cr (median 334.0 vs. 97.3 nmol/L respectively). Nickel concentrations in whole blood, plasma, and urine were low relative to Co and Cr. The analysis shows fundamental differences in the physiological handling of these metals: Co is distributed approximately equally between blood cells and plasma, whereas Cr is mainly in plasma, despite which, Cr had far less renal excretion than Co.
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Affiliation(s)
- Ashley W Newton
- Department of Clinical Biochemistry and Metabolic Medicine, Royal Liverpool University Hospital, University of Liverpool, Prescot Street, Liverpool L7 8XP, United Kingdom.
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Reclaru L, Unger R, Kirkpatrick C, Susz C, Eschler PY, Zuercher MH, Antoniac I, Lüthy H. Ni–Cr based dental alloys; Ni release, corrosion and biological evaluation. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2012; 32:1452-60. [DOI: 10.1016/j.msec.2012.04.025] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 02/24/2012] [Accepted: 04/19/2012] [Indexed: 11/26/2022]
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