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Systemic cobalt toxicity from total hip arthroplasties: review of a rare condition Part 2. measurement, risk factors, and step-wise approach to treatment.
- Source :
-
The bone & joint journal [Bone Joint J] 2016 Jan; Vol. 98-B (1), pp. 14-20. - Publication Year :
- 2016
-
Abstract
- Unlabelled: As adverse events related to metal on metal hip arthroplasty have been better understood, there has been increased interest in toxicity related to the high circulating levels of cobalt ions. However, distinguishing true toxicity from benign elevations in cobalt levels can be challenging. The purpose of this review is to examine the use of cobalt alloys in total hip arthroplasty, to review the methods of measuring circulating cobalt levels, to define a level of cobalt which is considered pathological and to review the pathophysiology, risk factors and treatment of cobalt toxicity. To the best of our knowledge, there are 18 published cases where cobalt metal ion toxicity has been attributed to the use of cobalt-chromium alloys in hip arthroplasty. Of these cases, the great majority reported systemic toxic reactions at serum cobalt levels more than 100 μg/L. This review highlights some of the clinical features of cobalt toxicity, with the goal that early awareness may decrease the risk factors for the development of cobalt toxicity and/or reduce its severity.<br />Take Home Message: Severe adverse events can arise from the release of cobalt from metal-on-metal arthroplasties, and as such, orthopaedic surgeons should not only be aware of the presenting problems, but also have the knowledge to treat appropriately.<br /> (©2016 The British Editorial Society of Bone & Joint Surgery.)
- Subjects :
- Aged
Animals
Chelating Agents therapeutic use
Cobalt analysis
Disease Models, Animal
Female
Humans
Ions adverse effects
Ions analysis
Kidney Failure, Chronic complications
Long-Term Care
Male
Malnutrition complications
Metal-on-Metal Joint Prostheses
Middle Aged
Postoperative Complications therapy
Prosthesis Design
Rats
Risk Factors
Arthroplasty, Replacement, Hip adverse effects
Cobalt adverse effects
Hip Prosthesis adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 2049-4408
- Volume :
- 98-B
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The bone & joint journal
- Publication Type :
- Academic Journal
- Accession number :
- 26733510
- Full Text :
- https://doi.org/10.1302/0301-620X.98B1.36712