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At least 19 recordsLinked to original sources
PubMed2003

Metal sensitivities and orthopaedic implants revisited: the potential for metal allergy with the new metal-on-metal joint prostheses.

The potential of metal-containing orthopaedic prostheses to induce problems through metal allergy taxes dermatologists and orthopaedic surgeons alike. Metal-on-plastic joint replacements are not thought to induce metal allergy but wear products, principally polypropylene particles, produce a foreign body reaction in bone and may lead to aseptic loosening of the joint. Orthopaedic surgeons are increasingly using metal-on-metal joint replacements, particularly for younger patients, as some evidence suggests that there is less wear debris and hence less aseptic loosening. The original metal-on-metal hip joints of the 1960s were associated with sensitivities to cobalt, nickel and chromate when loosening occurred. The potential for modern metal-on-metal joint prostheses, with their lower production of wear debris, to sensitize the recipient to metals or to induce a problem in subjects already allergic to metals, is unclear. One uncontrolled series suggested an association between nickel allergy and prosthesis loosening in some subjects, but the question has yet to be addressed in a prospective study and to date there is no other observation in the orthopaedic literature to suggest a problem.

Dermatitis↗
PubMed1986

Cytotoxicity of metals, metal-metal and metal-chelator combinations assayed in vitro.

A simple, rapid assay, based on the lysosomal incorporation of neutral red by cells, conveniently carried out in 96-well microtiter plates, was used to evaluate the cytotoxic effect of cationic and anionic metal salts on BALB/c mouse 3T3 fibroblasts. Ranking of the metals according to their decreasing potency was based on spectrophotometrically determined absorbance of the neutral red, extracted from surviving viable cells. The rank order was Cd greater than Hg greater than Ag greater than Zn greater than Mn greater than Cu greater than Co greater than Ni greater than Cr(III) for the cationic metals and Cr2O7 greater than CrO4 greater than AsO2 greater than AsO4 greater than SeO3 greater than SeO4 greater than MnO4 for the anionic metals tested. Cationic metals incubated with cultures in medium containing 1% fetal bovine serum (FBS) were 3-4 times more toxic than in medium with 10% FBS. Cadmium served as a representative metal for the use of this assay not only for concentration, but also for time dependent exposures. Thus a 10% cytotoxic effect after 1 h of incubation with 60 microM cadmium was increased to 90% after 6 h. Examination of the effect of metal-metal interaction on cytotoxicity showed a marked reduction of cadmium toxicity by zinc and to a lesser degree, by nickel. The neutral red assay was also effectively used to investigate the effect of the chelators ethylenediaminetetraacetic acid (EDTA), nitrilotriacetic acid (NTA) and 2,3-dimercaptosuccinic acid (DMSA) on cadmium-induced injury. Cytotoxicity by cadmium was completely inhibited by EDTA, and partially by NTA, but DMSA was ineffective. Reduction of copper toxicity by chelation was less efficient than for cadmium. Use of a chelator as therapy against metal poisoning was only partially effective and limited to administration within 2 h after incubation of cells with cadmium. It is believed that the neutral red assay can be a valuable tool for the screening of cytotoxic and potentially therapeutic agents under controlled in vitro conditions.

Absorption↗
PubMed1992

Synthetic metal-binding protein surface domains for metal ion-dependent interaction chromatography. II. Immobilization of synthetic metal-binding peptides from metal ion transport proteins as model bioactive protein surface domains.

This preliminary investigation tests the premise that biologically relevant (1) peptide-metal ion interactions, and (2) metal ion-dependent macromolecular recognition events (e.g., peptide-peptide interactions) may be modeled by biomimetic affinity chromatography. Divinylsulfone-activated agarose (6%) was used to immobilize three different synthetic peptides representing metal-binding protein surface domains from the human plasma metal transport protein histidine-rich glycoprotein (HRG). The synthetic peptides represented 1-3 multiple repeat units of the 5-residue sequence (Gly-His-His-Pro-His) found in the C-terminal of HRG. By frontal analyses, immobilized HRG peptides of the type (GHHPH)nG, where n = 1-3, were each found to have a similar binding capacity for both Cu(II) ions and Zn(II) ions (31-38 mumol/ml gel). The metal ion-dependent interaction of a variety of model peptides with each of the immobilized HRG peptide affinity columns demonstrated differences in selectivity despite the similar internal sequence homology and metal ion binding capacity. The immobilized 11-residue HRG peptide was loaded with Cu(II) ions and used to demonstrate selective adsorption and isolation of proteins from human plasma. These results suggest that immobilized metal-binding peptides selected from known solvent-exposed protein surface metal-binding domains may be useful model systems to evaluate the specificity of biologically relevant metal ion-dependent interaction and transfer events in vitro.

Amino Acid Sequence↗
PubMed2006

On the paucity of molecular actinide complexes with unsupported metal-metal bonds: a comparative investigation of the electronic structure and metal-metal bonding in U2X6 (X = Cl, F, OH, NH2, CH3) complexes and d-block analogues.

Density functional calculations have been performed on M2X6 complexes (where M = U, W, and Mo and X = Cl, F, OH, NH2, and CH3) to investigate general aspects of their electronic structures and explore the similarities and differences in metal-metal bonding between f-block and d-block elements. A detailed analysis of the metal-metal interactions has been conducted using molecular orbital theory and energy decomposition methods. Multiple (sigma and pi) bonding is predicted for all species investigated, with predominant f-f and d-d metal orbital character, respectively, for U and W or Mo complexes. The energy decomposition analysis involves contributions from orbital interactions (mixing of occupied and unoccupied orbitals), electrostatic effects (Coulombic attraction and repulsion), and Pauli repulsion (associated with four-electron two-orbital interactions). The general results suggest that the overall metal-metal interaction is stronger in the Mo and W species, relative to the U analogues, as a consequence of a significantly less destabilizing contribution from the combined Pauli and electrostatic ("pre-relaxation") effects. Although the orbital-mixing ("post-relaxation") contribution to the total bonding energy is predicted to have a larger magnitude in the U complexes, this is not sufficiently strong to compensate for the comparatively greater destabilization that originates from the Pauli-plus-electrostatic effects. Of the pre-relaxation terms, the Pauli repulsion is comparable in analogous U and d-block compounds, contrary to the electrostatic term, which is (much) less favorable in the U systems than in the W and Mo systems. This generally weak electrostatic stabilization accounts for the large pre-relaxation destabilization in the U complexes and, ultimately, for the relative weakness of the U-U bonds. The origin of the small electrostatic term in the U compounds is traced primarily to MX(3) fragment overlap effects.

Journal Article↗
PubMed2005

Metal-metal bond or isolated metal centers? Interaction of Hg(CN)2 with square planar transition metal cyanides.

Three adducts have been prepared from Hg(CN)(2) and square planar M(II)(CN)(4)(2)(-) transition metal cyanides (M = Pt, Pd, or Ni, with d(8) electron shell) as solids. The structure of the compounds K(2)PtHg(CN)(6).2H(2)O (1), Na(2)PdHg(CN)(6).2H(2)O (2), and K(2)NiHg(CN)(6).2H(2)O (3) have been studied by single-crystal X-ray diffraction, XPS, Raman spectroscopy, and luminescence spectroscopy in the solid state. The structure of K(2)PtHg(CN)(6).2H(2)O consists of one-dimensional wires. No CN(-) bridges occur between the heterometallic centers. The wires are strictly linear, and the Pt(II) and Hg(II) centers alternate. The distance d(Hg)(-)(Pt) is relatively short, 3.460 A. Time-resolved luminescence spectra indicate that Hg(CN)(2) units incorporated into the structure act as electron traps and shorten the lifetime of both the short-lived and longer-lived exited states in 1 compared to K(2)[Pt(CN)(4)].2H(2)O. The structures of Na(2)PdHg(CN)(6).2H(2)O and K(2)NiHg(CN)(6).2H(2)O can be considered as double salts; the lack of heterometallophilic interaction between the remote Hg(II) and Pd(II) atoms, d(Hg)(-)(Pd) = 4.92 A, and Hg(II) and Ni(II) atoms, d(Hg)(-)(Ni) = 4.61 A, is apparent. Electron binding energy values of the metallic centers measured by XPS show that there is no electron transfer between the metal ions in the three adducts. In solution, experimental findings clearly indicate the lack of metal-metal bond formation in all studied Hg(II)-CN(-)-M(II)(CN)(4)(2)(-) systems (M = Pt, Pd, or Ni).

Journal Article↗
PubMed1996

Cancer risk after metal on metal and polyethylene on metal total hip arthroplasty.

The incidence of cancer after metal on metal total hip arthroplasty (McKee-Farrar) and polyethylene on metal total hip arthroplasty (Brunswik, Lubinus) was compared with that of the general population in Finland. The mean followup time for the patients who had metal on metal total hip arthroplasty was 15.7 (9092 person years) and for the patients who had polyethylene on metal total hip arthroplasty it was 12.5 years (19,846 person years). One hundred thirteen malignant cancers were observed in patients who had metal on metal total hip arthroplasty and 212 were observed in patients who had polyethylene on metal total hip arthroplasty. The standardized incidence ratio for all cancers of the metal on metal arthroplasty group was 0.95 (95% confidence limits 0.79-1.13) and that of the polyethylene on metal arthroplasty group was 0.76 (95% confidence limits 0.68-0.86). The risk of total cancer in the patients who had metal on metal total hip arthroplasty was 1.23-fold compared with that of the patients who had polyethylene on metal total hip arthroplasty. Both groups had significantly less lung cancer than the general population: the leukemia incidence in the patients who had metal on metal total hip arthroplasty was slightly increased (observed to experienced 7/3.03, standardized incidence ratio 0.61; 95% confidence limits 0.17-1.56). The leukemia rate of the patients who had metal on metal total hip arthroplasty was 3.77-fold compared with that of the patients who had polyethylene on metal total hip arthroplasty, but this difference was not statistically significant. No sarcomas were observed at the site of the prosthesis. The incidence of the other forms of cancers did not differ significantly from those in the general population. The observed variation in the incidence of different cancers among patients who had total hip arthroplasty compared with the general population suggests that factors other than total hip arthroplasty play a major role in the origin of cancer.

Aged↗
PubMed1999

Metal-on-metal bearing in hip prosthesis generates 100-fold less wear debris than metal-on-polyethylene.

Aseptic loosening due to osteolysis in total hip replacement has been related to wear debris released from prosthetic components. Retrospective longterm observations of patients with the metal-on-metal prosthesis has shown long-term survivorship and good mechanical performance. Thus, the new and modified metal-on-metal prosthesis has been introduced on the market. Historical clinical data from the 1st generation metal-on-metal hip prosthesis may not be relevant for the 2nd generation of metal-on-metal hip prosthesis. Therefore, preclinical testing of the prosthesis must be conducted before clinical evaluation. We assessed the tribological performance of the metal-on-metal prosthesis versus the metal-on-polyethylene prosthesis introduced on the market as Metasul and Protasul, respectively. In a 12-channel joint simulator, 6 metal-on-metal bearing and 3 metal on polyethylene prostheses were tested, with the same number of corresponding soak controls. The wear was assessed gravimetrically. The "steady-state" wear-rates from the metal-on-metal prosthesis were almost 100 times less than that from the metal-on-polyethylene prosthesis. The tribological wear performance of the metal-on-metal hip prosthetic system is promising.

Hip Prosthesis↗
PubMed2006

Effectiveness of metal-metal and metal-organic compound combinations against Plutella xylostella: implications for plant elemental defense.

Plants that contain elevated foliar metal concentrations can be categorized as accumulators or, if the accumulation is extreme, hyperaccumulators. The defense hypothesis suggests that these plants may be defended against folivore attack, and recent research has indicated that metal concentrations at or below the accumulator range may be defensively effective. This experiment explored the toxicity of four metals hyper-accumulated by plants (Cd, Ni, Pb, and Zn) and asked if combinations of metals, or metals and organic chemicals, might broaden the defensive effectiveness of metals. Metals were used alone and in certain metal + metal (Zn plus Ni, Pb, or Cd) and metal + organic defensive chemical (Ni plus tannic acid, atropine, or nicotine) combinations. Artificial diet amended with these treatments was fed to larvae of the crucifer specialist herbivore Plutella xylostella. Combinations of metals and metals + organic chemicals significantly decreased survival and pupation rates, compared to single treatments, for at least some concentrations in every experiment. Effects of combinations were additive rather than synergistic or antagonistic. Because Zn enhanced the toxicity of other metals and Ni enhanced the toxicity of organic defensive chemicals, our findings suggest that the defensive effects of metals are more widespread among plants than previously believed. They also support the hypothesis that herbivore defense may have led to the evolution of metal hyper-accumulation by increasing the preexisting defensive effects of metals at accumulator levels in plants.

Animals↗
PubMed2006

Characterisation of wear particles produced by metal on metal and ceramic on metal hip prostheses under standard and microseparation simulation.

The failure of metal on polyethylene total hip replacements due to wear particle induced osteolysis and late aseptic loosening has focused interest upon alternative bearings, such as metal on metal implants. A recent advance in this field has been the development of a novel ceramic on metal implant. The characteristics of the wear particles generated in this low-wearing bearing have not been previously determined. The aims of this study were to characterise metal wear particles from metal on metal and ceramic on metal hips under standard and adverse (microseparation) wear conditions. Accurate characterisation of cobalt-chrome wear particles is difficult since the reactive nature of the particles prevents them from being isolated using acids and bases. A method was developed to isolate the metal wear particles using enzymes to digest serum containing lubricants from metal on metal and ceramic on metal hip simulations. High resolution scanning electron microscopy was then used to characterise the wear particles generated by both metal on metal and ceramic on metal implants under standard and microseparation wear conditions. The wear particles isolated from all simulations had a mean size of less than 50 nm with a rounded and irregular morphology. No significant difference was found between the size of wear particles generated under any conditions.

Ceramics↗
PubMed1996

Metal on metal bearings. A practical alternative to metal on polyethylene total joints?

Metal on metal articulation is proposed as an alternative to metal on polymer in total hip replacement arthroplasty as a technical means of reducing wear debris production and subsequent osteolysis leading to the need for surgical revision. The question of whether metal on metal articulation is a practical alternative to current practice is essentially that of whether it is as safe as, and more effective than, metal on polymer articulations in use for more than 20 years. Unfortunately, the metal on metal articulation introduces additional biologic risks associated with production of increased metallic corrosion and wear products. The clinical longevity and success of metal on polymer articulation in total hip replacements, as embodied in the Charnley type, is such that it may prove humanly impossible to determine that metal on metal articulations are more effective, even if that is objectively the case. Therefore, it is suggested that, consistent with modern technical and ethical standards, it cannot be concluded that metal on metal articulation is a practical alternative to current metal on polymer designs. It is suggested that future improvement in total hip replacement arthroplasty outcome is more likely to be through evolutionary than revolutionary designs.

Adult↗
PubMed2002

In vivo comparison of hip separation after metal-on-metal or metal-on-polyethylene total hip arthroplasty.

BACKGROUND: Twenty subjects were analyzed in vivo with use of video fluoroscopy to determine if the femoral head separates from the acetabular component during normal gait and to determine if the amount of separation differs between metal-on-metal and metal-on-polyethylene total hip prostheses. METHODS: Ten subjects had been treated with a metal-on-metal total hip arthroplasty and ten, with a metal-on-polyethylene total hip arthroplasty. All of the prostheses were implanted by the same surgeon utilizing the same surgical technique, and all were judged to be clinically successful (a Harris hip score of >90 points). Each subject walked with a normal gait on a level treadmill while under fluoroscopic surveillance. The two-dimensional fluoroscopic videotapes were then converted into three-dimensional images with use of a computer-automated model-fitting technique. Each implant was analyzed at various flexion angles to assess the amount of femoral head sliding. RESULTS: No femoral head sliding was observed in the subjects with a metal-on-metal implant, whereas all ten subjects with a metal-on-polyethylene implant had sliding that was greater than our threshold value of 0.75 mm. The average amount of femoral head sliding in these subjects was 2.0 mm, and the sliding was observed during the swing phase of gait. The sliding was typically seen medially while the femoral head remained in contact with the acetabular component superolaterally. CONCLUSIONS: Femoral head sliding commonly occurred following traditional metal-on-polyethylene total hip arthroplasty but not after metal-on-metal arthroplasty. These kinematic data may be of value in future hip-simulation studies to better duplicate wear patterns observed in retrieval analyses, assist in the understanding of the lubrication and wear rates of metal-on-metal designs, and facilitate designing of prosthetic components that minimize wear and optimize hip kinematics.

Acetabulum↗
PubMed2002

Ion release in patients with metal-on-metal hip bearings in total joint replacement: a comparison with metal-on-polyethylene bearings.

Polyethylene (PE) wear has been shown to be a problem in long-term joint replacement using metal-on-PE bearing. The use of metallic heads articulating with metallic cups could solve this problem: success will be enhanced if wear and corrosion of the articulating surfaces are maintained at a low level. New models with metal-on-metal bearing have been proposed, to be used mainly for young subjects: such coupling seems to have a reduced release, but it is unclear yet if the medium-term corrosion rate is really negligible or, on the contrary, it is significantly higher than in the metal-on-PE bearing. Aim of our study was the comparison of ion release in the serum of two groups of patients who had the same type of stable cementless prosthesis, but different bearing: twenty-six patients with metal-on-metal (Group A) and fifteen patients with metal-on-PE bearing (Group B) were examined. The follow-up was 14-38 months for group A and 18-34 months for group B. The serum concentration of chromium (Cr), cobalt (Co) and molybdenum (Mo) was measured. Twenty-two patients before surgery were used for comparison (Group C). The reference values were obtained from a population of twenty-two healthy subjects (Group D). Our findings indicate that metal-on-metal bearings produce a significantly higher systemic release of cobalt and chromium (ng/ml) when compared with levels found in metal-on-PE, pre-surgery and reference groups. Such a high release should induce to improve the bearing materials or, at least, to study the biologic fate of metal ions and consequently their long-term effects. In such a way a risk-to-benefit ratio for the patient could be established.

Adult↗
PubMed2002

Elucidation of primary (alpha(3)N) and vestigial (alpha(5)) heavy metal-binding sites in Staphylococcus aureus pI258 CadC: evolutionary implications for metal ion selectivity of ArsR/SmtB metal sensor proteins.

Despite a common evolutionary origin, individual members of the ArsR/SmtB family of bacterial metal-responsive transcriptional repressors sense a wide range of heavy-metal ions. The molecular basis for this metal ion selectivity is unclear. Here, we establish that Staphylococcus aureus plasmid pI258 CadC, a Cd(II)/Pb(II)/Bi(III)/Zn(II) sensor, contains two distinct metal-binding sites: a thiolate-rich alpha(3)N site comprised exclusively of cysteine ligands that preferentially binds larger, softer metal ions such as Cd(II), Pb(II) and Bi(III); and a second C-terminal alpha(5) site, found at the dimer interface, that is devoid of cysteine ligands and preferentially binds smaller, harder metal ions [Co(II) and Zn(II)] concurrently with metal binding to the alpha(3)N site. Optical absorption and X-ray spectroscopies reveal that the alpha(3)N site can adopt distinct coordination geometries in order to accommodate different metal ions, i.e. Cd(II), Bi(III), Co(II) and Zn(II) form distorted tetrahedral S(4) complexes, while Pb(II) adopts a trigonal S(3) complex. Characterization of mutant CadCs reveals that the alpha(3)N site is composed of Cys58 and Cys60 from the alpha(3) helix of the helix-turn-helix DNA-binding domain and Cys7 and/or Cys11 from the N-terminal "arm" of CadC; Cys11 is excluded from the Pb(II) coordination sphere. Only the thiolate-rich alpha(3)N site is metalloregulatory for repressor binding to a fluorescein-labeled cad O/P oligonucleotide upon coordination to Cd(II), Pb(II), Bi(III), Zn(II), and weakly for Co(II). Substitution of Cys60 and Cys7 with non-ligating residues specifically abrogates metal-dependent negative regulation of cad O/P binding, despite the fact that C60G and C7G CadCs maintain high affinity for metals in altered coordination complexes. These findings reveal that formation of metal coordination bonds to Cys7 and Cys60 play primary roles in transducing the allosteric response in CadC. The evolutionary implications for metal ion selectivity of ArsR/SmtB metal sensor proteins are discussed.

Allosteric Regulation↗
PubMed2003

Functional metal-binding proteins by metal-stimulated bacteria for the development of an innovative metal removal technology.

Heavy metal pollution has become an environmental problem throughout the world because heavy metal can be accumulated into the food chain and bring about serious problems, not only for ecosystems but also for human health. In this study, functional metal-binding proteins (FMBPs) were isolated from a metal-stimulated activated sludge culture with the aim of applying them to an innovative metal removal technology. Activated sludge bacteria was cultured in growth media including copper ion, and the stimulation of protein production by copper ion led to the 14% increase in a quantity of extracted crude proteins per 1 g of bacterial cell pellet (wet). In order to isolate FMBPs, extracted crude proteins were applied to the immobilized metal affinity column in which each of copper, nickel and zinc was used as a ligand. Several FMBPs were succesfully isolated from copper-stimulated bacteria. One of FMBPs (molecular weight of about 40 kDa) exhibited an ability to adsorb all three metals. The multi metal-binding property of this FMBP could be applied to an innovative metal removal technology. Furthermore, isolated FMBPs that could capture only one kind of heavy metal would also be attractive as a metal adsorbent in recovering a specific metal as a resource from wastewater, including several heavy metals.

Adsorption↗
PubMed2003

Chemical structures from the analysis of domain-averaged Fermi holes: multiple metal-metal bonding in transition metal compounds.

The recently proposed approach based on the analysis of domain-averaged Fermi holes was applied to the study of the nature of metal-metal bonding in transition metal complexes and clusters. The main emphasis was put on the scrutiny of the systems assumed to contain direct multiple metal-metal bonds. The studied systems involve: (1) systems of the type M(2)X(6) (M = Mo, W, X = CH(3)) anticipated to contain metal-metal triple bonds; (2) the molecule of W(2)Cl(8) ((4-)) as the representative of the systems with quadruple metal-metal bonding; (3) diatomic molecules Mo(2) and V(2) considered as the potential candidates for higher than quadruple metal-metal bonding. Although the resulting picture of bonding has been usually shown to agree with the original expectations based on early simple MO models, some examples were also found in which the conclusions of the reported analysis display dramatic sensitivity to the quality of the wave function used for the generation of the Fermi holes. In addition to this we also report some examples where the original theoretical predictions of multiplicity of metal-metal bonds have to be corrected.

Journal Article↗
PubMed2002

Is metal extraction by Arabidopsis halleri related to exchangeable metal rates in soils amended with different metal-bearing solids?

Metals are associated to various constituents in polluted soils, and their availability is closely related to their chemical speciation. Studies on relations between metal extraction efficiency by hyperaccumulators and location of metals with respect to soil constituents are scarce. In this study. we investigate the relationship between metal extraction by Arabidopsis halleri and the exchangeable metals from substrates amended with various metal-bearing solids collected in the vicinity of a Zn smelter complex. These consisted of fresh and decomposing organic matter, the soil clay fraction, and two types of waste slags. ZnSO4 was also used as metal-bearing solid. Each was mixed with an unpolluted soil to produce two types of substrate, one moderately polluted and the other highly polluted. Total Zinc, Cd, Cu, and Pb were measured in substrates and in roots and shoots of A. halleri. Analysis of 0.01 M CaCl2 exchangeable metals in each substrate was performed before and after plant growth. The results showed different concentrations of exchangeable metals after plant growth, depending on the nature of the metal-bearing solids. In the ZnSO4 soil substrate, the proportion of exchangeable Zn decreased after plant growth, whilst it increased significantly on substrates amended with the two waste slags. For the other substrates, exchangeable Zn was not significantly different before and after plant growth. The same trend was observed for Cd. In the case of Cu, exchangeable rates increased in all substrates. The results were discussed according to the characteristics of the metal-bearing solids and to the metal-uptake strategy of A. halleri.

Arabidopsis↗
PubMed2005

Metal ion levels after metal-on-metal proximal femoral replacements: a 30-year follow-up.

Metal-on-metal hip bearings are being implanted into younger patients. The consequence of elevated levels of potentially carcinogenic metal ions is therefore a cause for concern. We have determined the levels of cobalt (Co), chromium (Cr), titanium (Ti) and vanadium (Va) in the urine and whole blood of patients who had had metal-on-metal and metal-on-polyethylene articulations in situ for more than 30 years. We compared these with each other and with the levels for a control group of subjects. We found significantly elevated levels of whole blood Ti, Va and urinary Cr in all arthroplasty groups. The whole blood and urine levels of Co were grossly elevated, by a factor of 50 and 300 times respectively in patients with loose metal-on-metal articulations when compared with the control group. Stable metal-on-metal articulations showed much lower levels. Elevated levels of whole blood or urinary Co may be useful in identifying metal-on-metal articulations which are loose.

Adolescent↗
PubMed2004

Immune responses correlate with serum-metal in metal-on-metal hip arthroplasty.

Cell-mediated hypersensitivity associated with metal components may be related to levels of implant debris. We tested this hypothesis by comparing lymphocyte reactivity to soluble Co, Cr, Ni, and Ti of patients with metal-on-polyethylene and metal-on-metal arthroplasties with healthy controls, and patients with osteoarthritis. The metal-on-metal group (n=9) demonstrated significantly elevated serum Co and Cr concentrations (13- and 58-fold, P<.05, respectively) and significantly elevated lymphocyte reactivity to Co (SI>5, P<.004) and Ni (SI>2.5, P<.01) when compared to controls (n=12) and subjects with metal-on-poly implants (n=7). These elevated in vivo metal levels demonstrated positive linear correlation with lymphocyte reactivity supporting our hypothesis that lymphocyte metal-induced reactivity increases with increased metal exposure. These results represent the first direct link between in vivo metal exposure and lymphocyte reactivity. Whether this lymphocyte reactivity to metal debris is etiologically linked to poor implant performance remains uncertain.

Aged↗