Allergic and Systemic Effects of Particles Released by Hips and Knee Replacements

R. M. Urban and J. J. Jacobs (download paper here)

Total hip and knee replacement prostheses generate wear and corrosion products at their bearing surfaces, at modular junctions, and at interfaces with cement or bone.

• Large numbers of these particles result in the formation of foreign-body granulation tissue, osteolysis and, in some cases, aseptic loosening requiring revision of the hip or knee.
• The potential immunologic problems and the possible systemic effects of widespread dissemination of metallic and polymeric degradation products are not well understood – but there are plenty of clues!
• In the vast majority of patients, permanent metallic orthopaedic implants are biocompatible and will continue to be used by orthopaedic surgeons.
• When applied appropriately, these devices have had a history of success with few serious short and long-term problems.
• However, in certain situations and in particular individuals, adverse biological effects may occur which can compromise the clinical outcome.

My view:

This paper is another from a Symposia series – good reading and theme is much the same as most papers – cobalt chrome DOES corrode in hip and knee replacements and this affects some people and not others. Other Papers from the Symposia Series:

• Alternative Bearing Surfaces

• Metal Ion Hypersensitivity in Metal-on-Metal Hip Arthroplasty

Related articles

• Associate Professor Michael J. Neil – Doesn’t Recommend Resurfacing (earlsview.com)
• MHRA Advice for Patients (earlsview.com)
• Obese Are Three Times as Likely to Need a Hip or Knee Replacement (earlsview.com)
• Advances in Knee Replacement Surgery for Active Baby Boomers (earlsview.com)
• Smoking Tied to Increase in Post-Arthroplasty Complications – Bugger!!! (earlsview.com)