Cancer Risk After Metal on Metal and Polyethylene on Metal Total Hip Arthroplasty

Visuri, Tuomo; Pukkala, Eero; Paavolainen, Pekka; Pulkkinen, Pekka; Riska, Erik B.

doi:10.1097/00003086-199608001-00025

Cited by 249 publications

(142 citation statements)

References 33 publications

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“…Theoretically, there is potential risk of mutagenicity and hypersensitivity [33,35]. In fact, the carcinogenic risk is not increased in subjects receiving metalon-metal hip prostheses compared to those with metal-onpolyethylene hip prostheses [33,37]. All metal implants release metal ions because of corrosion effects for instance after total knee arthroplasty which show metallic ion levels similar to those in metal-on-metal hip arthroplasty [22].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hip resurfacing in patients under thirty years old: an attractive option for young and active patients

Krantz

Miletic

Migaud

et al. 2012

International Orthopaedics (SICOT)

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Section: Discussionmentioning

confidence: 99%

“…To date, no reports of mutagenic/teratogenic effects in patients with metal-on-metal total hip arthroplasty have been published [37]. The placenta could modulate the rate of metallic ion (cobalt and chromium) transfer and to date there has been no significant effect on the child [26].…”

Section: Discussionmentioning

confidence: 99%

Hip resurfacing in patients under thirty years old: an attractive option for young and active patients

Krantz

Miletic

Migaud

et al. 2012

International Orthopaedics (SICOT)

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“…As reported in the literature, measurements of serum levels of metals might have been useful for initial diagnosis [11]. Apparently, there is no increase in the incidence of malignancies in patients exposed to metal particles [12], but in patients with metal-on-metal bearings, hypersensitivity to metals is higher than in normal population, especially in those with failed implants [9,13]. Massive wear and extensive metallosis must be avoided.…”

Section: Discussionmentioning

confidence: 99%

Catastrophic Wear in a Metal-On-Ceramic Total Hip Arthroplasty

Valentí

Rı́o

Amillo

2007

The Journal of Arthroplasty

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A 51-year-old woman came to our clinic 6 months after a right total hip arthroplasty. She had noticed a slowly growing mass in the proximal thigh and referred progressive pain in the right groin. Plain radiography revealed premature acetabular cup aseptic loosening, and in the computed tomography study, a 14-cm-diameter mass was observed. Revision surgery was performed, showing a metal-on-ceramic bearing surface. The histologic analysis of surrounding tissues was reported as massive metallosis. Although occasionally chosen for primary or revision hip arthroplasty, there is little information available about the in vivo wear behavior of this combination. This important fact should be taken into account before considering such a surface alternative.

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“…In the CoCr alloys, Cr and Ni have established carcinogenic compounds, and Co is classified as a possible carcinogen itself. 1 Evidence of these effects in experimental studies in vitro and in vivo raised a question about the possible increased risk of local and remote neoplasm in patients who underwent joint replacement. Several authors compared the incidence of neoplasm in the general population against that in patients with joint prostheses.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 In a later study, Visuri et al compared a cohort of patients with McKee-Farrar prostheses with patients with metal-on-polyethylene articulation: Both cohorts showed a lower incidence of cancer with respect to the general population, but the risk was lower in the metalpolyethylene group than in the metal-metal group. 1 The release of metal particles and ions from the McKee-Farrar prostheses was hypothesized to be the cause of the increased risk of lymphoma and leukemia. 6,7 The interest about the McKee-Farrar study was renewed since, metal-on-metal articulation from cobalt-chromiummolybdenum alloy was reintroduced into hip arthroplasty as an alternative to polyethylene and ceramic components in 1988.…”

Section: Introductionmentioning

confidence: 99%

Ion release and chromosomal damage from total hip prostheses with metal‐on‐metal articulation

et al. 2003

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A prospective multicentric study was carried out in patients having metal-onmetal METASUL components (Sulzer Medica, Winterthur, Switzerland) in order to check the following null hypotheses: H1: The concentration of Co, Cr, Ni, and Mb in blood and urine is not modified by the implant of a hip prosthesis with METASUL components at 6 months. H2: The incidence of markers of chromosomal damage [sister chromatid exchanges (SCEs) and micronuclei (Mni)] in lymphocytes is not modified by the implant of METASUL components at 6 months. H3: The concentrations of Co, Cr, Ni, and Mb in blood and urine did not correlate with the incidence of the markers of chromosomal damage. The measurements showed a 2-fold increase of Co in blood, a 10-fold increase of Co in urine, a 1.5-fold increase of Cr in the blood, and a 3-fold increase of Cr in the urine at a follow-up of 6 months from the operation; there was also a significant increase in the Ni blood concentration at the 7 day checkup. The study cohort did not show any modification in the frequency of markers of chromosomal damage in the peripheral lymphocytes at any of the observation times. The amount of the SCEs and Mni recorded at all the observation times did not correlate with each other or with any of the ion levels measured in the blood and in the urine.

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Cancer Risk After Metal on Metal and Polyethylene on Metal Total Hip Arthroplasty

Cited by 249 publications

References 33 publications

Hip resurfacing in patients under thirty years old: an attractive option for young and active patients

Hip resurfacing in patients under thirty years old: an attractive option for young and active patients

Catastrophic Wear in a Metal-On-Ceramic Total Hip Arthroplasty

Ion release and chromosomal damage from total hip prostheses with metal‐on‐metal articulation

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