Evaluation of Prosthetic Implant Degradation

Effect of Metallosis

December 2011

An important work published by DeSmet in the Journal of Bone and Joint Surgery in 2008 presented findings from a large population of hip implant patients, comparing these patients with signs and symptoms of metallosis to those without metallosis. DeSmet reported that the median serum chromium and cobalt concentrations in patients with metallosis are approximately 5 times the median value observed in patients without metallosis.

Results from the DeSmet study show complete differentiation of patients with metallosis compared to those without metallosis based on serum chromium or cobalt concentration. Joint synovial fluid concentration shows less discriminating capability in differentiating patients with metallosis and without metallosis; joint synovial fluid evaluation is not a good discrimanator for implant wear. Joint fluid represents the total metal implant environment, whereas the serum reflects implant wear-related micro-particles that have undergone corrosive dissolution.

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Effect of Metallosis

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Jump to section:

• Introduction
• Orthopedic Prostheses
• Background
• Patient Workup
• Issues of Concern
• Metal-on-Metal Wear-Induced Tissue Necrosis
• Metal-on-Metal Wear-Induced Tissue Necrosis
• Effect of Metallosis
• Initial Conclusions
• Interpretive Values
• Are These Concentrations Toxic?
• Are These Concentrations Toxic?
• Specimen Collection
• Metal-Free Blood Tubes
• Summary
• References/Additional Reading
• Questions?
• Disclosure (Dr. Sierra)
• Disclosure (Dr. Moyer)