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Prosthetic hip-associated cobalt toxicity.
- Source :
-
Journal of medical toxicology : official journal of the American College of Medical Toxicology [J Med Toxicol] 2013 Dec; Vol. 9 (4), pp. 416-7. - Publication Year :
- 2013
-
Abstract
- Prosthetic hip-associated cobalt toxicity (PHACT) is gaining recognition due to the use of metal-on-metal total hip replacements. Identifying true toxicity from merely elevated cobalt levels can be extremely difficult due to the lack of available data. An extensive review of the medical literature was undertaken to characterize cobalt toxicity from prosthetic hips. As an objective approach to making the diagnosis of PHACT, we suggest the following criteria: (1) elevated serum or whole blood cobalt levels due to a prosthetic hip, (2) at least two test-confirmed findings consistent with cobalt toxicity, and (3) exclusion of other etiologies. Adhering to objective diagnostic data for PHACT is a realistic and prudent method by which to eliminate the subjectivity of vague or difficult to identify complaints. These diagnostic criteria are not meant to evaluate prosthetic hardware failure, but as a means to identify systemic cobalt toxicity. Finally, assessment of cobalt toxicity from prosthetic hips should be done in conjunction with a medical toxicologist.
- Subjects :
- Biomarkers metabolism
Chelating Agents therapeutic use
Chelation Therapy
Cobalt metabolism
Device Removal
Humans
Metals, Heavy metabolism
Poisoning etiology
Poisoning metabolism
Poisoning therapy
Predictive Value of Tests
Prosthesis Design
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Arthroplasty, Replacement, Hip adverse effects
Arthroplasty, Replacement, Hip instrumentation
Cobalt poisoning
Heavy Metal Poisoning
Hip Prosthesis adverse effects
Metal-on-Metal Joint Prostheses adverse effects
Poisoning diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1937-6995
- Volume :
- 9
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of medical toxicology : official journal of the American College of Medical Toxicology
- Publication Type :
- Academic Journal
- Accession number :
- 24258006
- Full Text :
- https://doi.org/10.1007/s13181-013-0321-z