Metal carcinogenesis in total joint arthroplasty. Animal models

Area of Science:

• Biomaterials Science
• Oncology
• Orthopaedic Surgery

Background:

• Concerns regarding the carcinogenicity of dental and orthopaedic alloys emerged in 1956.
• Occupational studies linked nickel and chromate refining to increased nasal and lung tumor risks.
• Sporadic case reports have documented malignant neoplasms near orthopaedic implants over the past 25 years.

Purpose of the Study:

• To investigate the potential carcinogenicity of modern dental and orthopaedic alloys.
• To review laboratory studies on metal ion leaching and wear debris from implants.
• To recommend parameters for future laboratory investigations into implant-associated carcinogenesis.

Main Methods:

• Review of laboratory investigations into alloy carcinogenicity.
• Analysis of studies on metal ion leaching from implants.
• Examination of research on synovial processing of metallic wear debris and intraarticular particle effects.

Main Results:

• Epidemiologic studies have not confirmed an excessive tumor risk in patients with stainless steel or superalloy implants.
• Laboratory studies continue to explore carcinogenesis potential due to the corrosive in-vivo environment of implants.
• Research has focused on metal ion leaching, wear debris processing, and particle effects.

Conclusions:

• The potential for carcinogenesis from orthopaedic implants warrants continued laboratory investigation.
• Understanding metal ion behavior and particle effects is crucial for assessing implant safety.
• Defined parameters are recommended for future laboratory studies on implant-related cancer risks.