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Cobalt, chromium and molybdenum ions kinetics in the human body: data gained from a total hip replacement with massive third body wear of the head and neuropathy by cobalt intoxication
- Source :
- Archives of orthopaedic and trauma surgery. 131(9)
- Publication Year :
- 2010
-
Abstract
- A patient with a total hip replacement developed optic, acoustic and peripheral neuropathy from metal ions intoxication, due to the wear products released from the prosthesis. Subsequently the kinetics of the metal ions was studied.Massive wear and acute intoxication allowed a study of the metal ions kinetics and of EDTA treatment.Plasma and other organic fluids were saturated by each of the metal ions released from the exposed surface according to the solubility of each ion; a larger fraction of Co ions was bound within red cells, while the plasmatic fraction appeared more movable. In a patient with a prosthesis subjected to wear, the ions released are from the prosthetic and from the debris surface (spread in the body). The latter is a function of the number and size of particles.Revision of the prosthesis from the point of view of the metal ions kinetics corresponded to a reduction of the releasing surface because of debris washed out by irrigation and tissue excision; however, the metal particles spread by lymphatic circulation continued to release ions even though the source of wear had been removed. Early diagnosis of high metal wear can be ascertained with mass spectrometry and after revision high levels of metal ions can only be reduced with repeated chelating treatment. It is preferable not to revise fractured ceramic components with a polyethylene-metal articulation.
- Subjects :
- Chromium
Reoperation
medicine.medical_specialty
Metal ions in aqueous solution
Cobalt intoxication
Kinetics
Total hip replacement
chemistry.chemical_element
Prosthesis Design
Ion
Foreign body reaction
Optic Nerve Diseases
medicine
Humans
Orthopedics and Sports Medicine
Hearing Loss, Central
Metal ions
Edetic Acid
Chelating Agents
Molybdenum
business.industry
Radiochemistry
Peripheral Nervous System Diseases
Prosthetic wear
General Medicine
Cobalt
Middle Aged
medicine.disease
Surgery
Peripheral neuropathy
chemistry
Female
sense organs
Hip Prosthesis
business
Subjects
Details
- ISSN :
- 14343916
- Volume :
- 131
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Archives of orthopaedic and trauma surgery
- Accession number :
- edsair.doi.dedup.....1a393e0faf79c1511ad6fcf73ad83eb1