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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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Schoon J, Hesse B, Rakow A, Ort MJ, Lagrange A, Jacobi D, Winter A, Huesker K, Reinke S, Cotte M, Tucoulou R, Marx U, Perka C, Duda GN, Geissler S. Metal-Specific Biomaterial Accumulation in Human Peri-Implant Bone and Bone Marrow. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2020; 7:2000412. [PMID: 33101844 PMCID: PMC7578891 DOI: 10.1002/advs.202000412] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/09/2020] [Indexed: 05/13/2023]
Abstract
Metallic implants are frequently used in medicine to support and replace degenerated tissues. Implant loosening due to particle exposure remains a major cause for revision arthroplasty. The exact role of metal debris in sterile peri-implant inflammation is controversial, as it remains unclear whether and how metals chemically alter and potentially accumulate behind an insulating peri-implant membrane, in the adjacent bone and bone marrow (BM). An intensively focused and bright synchrotron X-ray beam allows for spatially resolving the multi-elemental composition of peri-implant tissues from patients undergoing revision surgery. In peri-implant BM, particulate cobalt (Co) is exclusively co-localized with chromium (Cr), non-particulate Cr accumulates in the BM matrix. Particles consisting of Co and Cr contain less Co than bulk alloy, which indicates a pronounced dissolution capacity. Particulate titanium (Ti) is abundant in the BM and analyzed Ti nanoparticles predominantly consist of titanium dioxide in the anatase crystal phase. Co and Cr but not Ti integrate into peri-implant bone trabeculae. The characteristic of Cr to accumulate in the intertrabecular matrix and trabecular bone is reproducible in a human 3D in vitro model. This study illustrates the importance of updating the view on long-term consequences of biomaterial usage and reveals toxicokinetics within highly sensitive organs.
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Affiliation(s)
- Janosch Schoon
- Julius Wolff InstituteCharité – Universitätsmedizin BerlinBerlin13353Germany
- Berlin Institute of Health Center for Regenerative TherapiesBerlin Institute of HealthBerlin10178Germany
- Berlin‐Brandenburg School for Regenerative TherapiesCharité – Universitätsmedizin BerlinBerlin13353Germany
| | - Bernhard Hesse
- Xploraytion GmbHBerlin10625Germany
- European Synchrotron Radiation FacilityGrenoble38000France
| | - Anastasia Rakow
- Berlin Institute of Health Center for Regenerative TherapiesBerlin Institute of HealthBerlin10178Germany
- Center for Musculoskeletal SurgeryCharité – Universitätsmedizin BerlinBerlin10117Germany
| | - Melanie J. Ort
- Julius Wolff InstituteCharité – Universitätsmedizin BerlinBerlin13353Germany
- Berlin Institute of Health Center for Regenerative TherapiesBerlin Institute of HealthBerlin10178Germany
- Berlin‐Brandenburg School for Regenerative TherapiesCharité – Universitätsmedizin BerlinBerlin13353Germany
| | - Adrien Lagrange
- Xploraytion GmbHBerlin10625Germany
- Department of Materials Science and EngineeringInstitute of Materials Science and TechnologiesTechnische Universität BerlinBerlin10623Germany
| | - Dorit Jacobi
- Julius Wolff InstituteCharité – Universitätsmedizin BerlinBerlin13353Germany
- Berlin Institute of Health Center for Regenerative TherapiesBerlin Institute of HealthBerlin10178Germany
| | | | - Katrin Huesker
- Endocrinology and Immunology DepartmentInstitute for Medical DiagnosticsBerlin12247Germany
| | - Simon Reinke
- Julius Wolff InstituteCharité – Universitätsmedizin BerlinBerlin13353Germany
- Berlin Institute of Health Center for Regenerative TherapiesBerlin Institute of HealthBerlin10178Germany
| | - Marine Cotte
- European Synchrotron Radiation FacilityGrenoble38000France
- CNRSLaboratoire d'archéologie moléculaire et structuraleLAMSSorbonne UniversitéParis75005France
| | - Remi Tucoulou
- European Synchrotron Radiation FacilityGrenoble38000France
| | | | - Carsten Perka
- Berlin Institute of Health Center for Regenerative TherapiesBerlin Institute of HealthBerlin10178Germany
- Berlin‐Brandenburg School for Regenerative TherapiesCharité – Universitätsmedizin BerlinBerlin13353Germany
- Center for Musculoskeletal SurgeryCharité – Universitätsmedizin BerlinBerlin10117Germany
| | - Georg N. Duda
- Julius Wolff InstituteCharité – Universitätsmedizin BerlinBerlin13353Germany
- Berlin Institute of Health Center for Regenerative TherapiesBerlin Institute of HealthBerlin10178Germany
- Berlin‐Brandenburg School for Regenerative TherapiesCharité – Universitätsmedizin BerlinBerlin13353Germany
| | - Sven Geissler
- Julius Wolff InstituteCharité – Universitätsmedizin BerlinBerlin13353Germany
- Berlin Institute of Health Center for Regenerative TherapiesBerlin Institute of HealthBerlin10178Germany
- Berlin‐Brandenburg School for Regenerative TherapiesCharité – Universitätsmedizin BerlinBerlin13353Germany
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