Evaluation of Prosthetic Implant Degradation

Are These Concentrations Toxic?

December 2011

Now let's move on to a key question: Are these chromium and cobalt concentrations toxic? Let's first explore information about chromium. Chromium is toxic when it is present in the chemical species known as chromium 6. Inhalation of chromium 6 vapors leads to pulmonary epithelial cancer. Chromium 6 is a by-product of electrolysis and is of concern in the chrome electroplating industry. When chromium 6 becomes exposed to tissues, it is instantly converted to chromium 3, by cellular reducing enzymes. Reduction of chromium 6 to chromium 3 releases electrons that are destructive to surrounding tissues, initiating the carcinogenic process. A key point to note is that chromium 3 is not toxic, and that only chromium 3 is released from orthopedic implants. There are a number of internet blogs and websites relying on the experience with chromium 6 exposure in the electroplating industry to make comments on the toxicity of chromium from hip implant deterioration. It is inappropriate to make that comparison, because chromium 6 is not released during implant wear.

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Are These Concentrations Toxic?

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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)