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Updated: May 5, 2026

Potentiodynamic Corrosion Testing

Potentiodynamic Corrosion Testing

Published on: September 4, 2016

Prosthetic hip-associated cobalt toxicity.

Anthony F Pizon¹, Michael Abesamis, Andrew M King

¹Division of Medical Toxicology, Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA, pizonaf@upmc.edu.

Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology

|November 22, 2013

Summary

Prosthetic hip-associated cobalt toxicity (PHACT) can be diagnosed using objective criteria. This approach helps differentiate true toxicity from elevated cobalt levels in patients with metal-on-metal hip implants.

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Published on: May 17, 2018

Area of Science:

Biomaterials Science
Toxicology
Orthopedic Surgery

Background:

Metal-on-metal total hip replacements are increasingly associated with cobalt toxicity.
Diagnosing prosthetic hip-associated cobalt toxicity (PHACT) is challenging due to limited data and subjective symptoms.
Elevated cobalt levels do not always equate to clinical toxicity.

Purpose of the Study:

To characterize cobalt toxicity associated with prosthetic hips.
To propose objective diagnostic criteria for PHACT.
To differentiate systemic cobalt toxicity from hardware failure.

Main Methods:

Extensive review of the medical literature on cobalt toxicity and prosthetic hips.
Development of a three-point diagnostic criteria for PHACT.
Emphasis on objective, test-confirmed findings and exclusion of other causes.

Main Results:

Proposed diagnostic criteria for PHACT include: 1) elevated cobalt levels linked to a prosthetic hip, 2) at least two confirmed signs of cobalt toxicity, and 3) exclusion of alternative etiologies.
These criteria aim to provide an objective method for diagnosing PHACT.
The criteria focus on identifying systemic cobalt toxicity, not prosthetic hardware failure.

Conclusions:

Objective diagnostic criteria are essential for accurately identifying prosthetic hip-associated cobalt toxicity.
Adherence to these criteria can reduce subjectivity in PHACT diagnosis.
Consultation with a medical toxicologist is recommended for assessing cobalt toxicity from prosthetic hips.