Evaluation of Prosthetic Implant Degradation

Are These Concentrations Toxic?

December 2011

Cobalt is an essential element. It is integral to Vitamin B12 and required for carbonic anhydrase activity. Cobalt toxicity, known as cobaltism, can occur after ingestion of large amounts of cobalt. Symptoms associated with cobaltism include myocardial damage, renal failure, hypothyroidism, and interstitial lung disease develops if cobalt is inhaled. There are only a few case reports suggesting any deleterious effect from orthopedic implant wear and high cobalt serum concentrations. The case reports point out nonspecific neurologic symptoms such as dyspnea, fatigue, headache, vertigo, and decreased cognition. These symptoms could be seen in most any patient experiencing continuous pain.

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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)