Prosthetic Metals: Release, Metabolism and Toxicity

Area of Science:

• Biomaterials Science
• Orthopedic Surgery
• Toxicology

Background:

• Metallic joint prostheses, primarily Cobalt-Chromium-Molybdenum (Co-Cr-Mo) and Titanium-Aluminum-Vanadium (Ti-Al-V) alloys, have been used for over a century in hip and knee arthroplasty.
• These alloys are chosen for their biocompatibility, mechanical strength, and corrosion resistance.
• However, wear, corrosion, and inflammation can lead to the release of metallic ions post-implantation.

Purpose of the Study:

• To review the historical development of metallic joint prostheses.
• To detail the in vivo fate of released prosthetic metals, including concentration, biodistribution, and elimination.
• To discuss the potential toxicities and adverse effects of these metals on organs, cells, biomolecules, and signaling pathways.

Main Methods:

• Literature review of joint prosthesis development.
• Analysis of studies reporting metallic ion concentration, biodistribution, and elimination pathways.
• Synthesis of research on the toxicological effects of released metals.

Main Results:

• Co-Cr-Mo and Ti-Al-V alloys are prevalent in joint replacements.
• Released metallic ions can circulate and metabolize within the body.
• Potential for local or systemic harm due to metal ion exposure.

Conclusions:

• Understanding the release and fate of prosthetic metals is crucial.
• Further research is needed to fully elucidate the toxicological profiles of these ions.
• This review provides a comprehensive overview of metal ion release and toxicity in joint arthroplasty.