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J Immunotoxicol 2022 Dec;19(1):61-73

Center for Devices and Radiological Health, FDA, Silver Spring, MD, USA.

Nickel titanium (NiTi, or Nitinol) alloy is used in several biomedical applications, including cardiac, peripheral vascular, and fallopian tube stents. There are significant biocompatibility issues of metallic implants to nickel ions and nano-/micro-sized alloy particles. Our laboratories have recently shown that microscale CoCr wear particles from metal-on-metal hips crosslink with the innate immune signaling Toll-like receptor 4 (TLR4), prompting downstream signaling that results in interleukin and gene expression. Read More

Commun Med (Lond) 2022 24;2:73. Epub 2022 Jun 24.

University Hospital of North Tees, Stockton, England.

Background: Over five million joint replacements are performed across the world each year. Cobalt chrome (CoCr) components are used in most of these procedures. Some patients develop delayed-type hypersensitivity (DTH) responses to CoCr implants, resulting in tissue damage and revision surgery. Read More

BMJ Case Rep 2022 Jun 27;15(6). Epub 2022 Jun 27.

Orthopaedic Surgery, Henry Ford Health System, Detroit, Michigan, USA.

A man in his late 30s developed non-ischaemic cardiomyopathy due to systemic cobalt toxicity associated with accelerated bearing surface wear from metal-on-metal hip resurfacing implanted in the previous 6 years. Following revision arthroplasty, the patient regained baseline cardiac function. Cobalt-induced cardiomyopathy is a grave condition that deserves early consideration due to potentially irreversible morbidity. Read More

J Funct Biomater 2022 May 23;13(2). Epub 2022 May 23.

Laboratory for Surface Technology and Tribology, Faculty of Engineering Technology, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands.

Due to various concerns about the use of metal-on-metal that is detrimental to users, the use of metal as acetabular cup material was later changed to ultra high molecular weight polyethylene (UHMWPE). However, the wear on UHMWPE releases polyethylene wear particles, which can trigger a negative body response and contribute to osteolysis. For reducing the wear of polyethylene, one of the efforts is to investigate the selection of metal materials. Read More

Regen Eng Transl Med 2021 Sep 29;7(3):247-261. Epub 2021 Jul 29.

Connecticut Convergence Institute for Translation in Regenerative Engineering, 263 Farmington Avenue, Farmington, CT 06030-3711, USA.

Metallosis is defined as the accumulation and deposition of metallic particles secondary to abnormal wear from prosthetic implants that may be visualized as abnormal macroscopic staining of periprosthetic soft tissues. This phenomenon occurs secondary to the release of metal ions and particles from metal-on-metal hip implants in patients with end-stage osteoarthritis. Ions and particles shed from implants can lead to local inflammation of surrounding tissue and less commonly, very rare systemic manifestations may occur in various organ systems. Read More