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The release of cobalt and chromium ions into serum is well known – but what has not been topical in the Press is the same release occurs when cobalt chrome is used for other medical prostheses – such as for the spine – see the scientific paper below.
Excerpts of Note:
Lhotka et al showed that the concentrations of metal ions for chromium and cobalt 4 years after THA were 50 times higher for cobalt and up to 100 times higher for chromium ions compared with a control group.
Maezawa et al also detected a statistically significant rise in the concentration of Cr ions in the serum from 1.05 to 1.61 μg/L within 3 years in 44 patients, following implantation of metal-on-metal total hip endoprostheses (Metasul).
Conversely, the study group of Brodner et al showed a constant concentration of Co ions in the serum over 5 years after the implantation of Metasul Co-28Cr-6Mo-0.2C metal-on-metal hip endoprosthetics.
The concentrations of cobalt and chromium ions in the serum as measured in our study amounted on average to 4.75 μg/L for cobalt and 1.93 μg/L for chromium. These values are similar or higher than the values shown in the literature following implantation of total hip endoprosthetics.[3,11,14]
Release of Cobalt and Chromium Ions Into the Serum Following Implantation of the Metal-on-Metal Maverick-Type Artificial Lumbar Disc (Medtronic Sofamor Danek)
Posted: 03/27/2007; Spine. 2007;32(3):348-352. © 2007 Lippincott Williams & Wilkins
Study Design: Cross-sectional study of 10 patients to measure the serum levels of cobalt and chromium after TDA.
Objectives: To investigate the release of cobalt and chromium ions into the serum following implantation of the metal-on-metal Maverick-type artificial lumbar disc.
Summary of Background Data: In total hip endoprosthetics and consequently for TDA (total disc arthroplasty), metal-on-metal combinations are used with the aim of reducing wear debris. In metal-on-metal TDA the release of metal ions has until now been secondary to the main discussion.
Materials and Methods: We investigated the serum cobalt and chromium concentration following implantation of 15 Maverick TDAs (monosegmental L5-S1, n = 5; bisegmental L4-L5 and L5-S1, n = 5; average age, 36.5 years). Five healthy subjects (no metal implants) acted as a control group. The measurements of the metals were carried out using the HITACHI Z-8200 AAS polarized Zeeman atomic absorption spectrometer after an average of 14.8 months.
Results: The concentrations of cobalt and chromium ions in the serum amounted on average to 4.75 μg/L (SD, 2.71) for cobalt and 1.10 μg/L (SD, 1.24) for chromium. Compared with control group, both the chromium and cobalt levels in the serum showed significant increases (Mann-Whitney U test, P = 0.0120). At follow-up,the Oswestry Disability Score was on average significantly decreased by 24.4 points (L5-S1) (t test, P < 0.05) and by 26.8 points (L4-S1) (t test, P < 0.05). The improved clinical situation is also represented by a significant decrease of the Visual Analog Pain Scale of 42.2 points after the follow-up (t test, P < 0.05).
Conclusion: Significant systemic release of Cr/Co was proven in the serum compared with the control group. The concentrations of Cr/Co measured in the serum are similar in terms of their level to the values measured in THA metal-on-metal combinations or exceed these values given in the literature. Long-term implication of this metal exposure in unknown and should be studied further.
Technorati Tags: Chrome Poisoning , Cobalt Ions, Metal Ions, metal wear debris, metallic particles, metallic synovitis, metallosis, orthopaedic implants, risk factors, soft tissue destruction, surgical safety, tissue damage, wear debris, Spinal implants, chromium ions
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