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Synchrotron analysis of human organ tissue exposed to implant material

DOI: 10.1016/j.jtemb.2017.12.007 DOI Help

Authors: Ilona Swiatkowska (University College London (UCL)) , J. Fred W. Mosselmans (Diamond Light Source) , Tina Geraki (Diamond Light Source) , Cody C. Wyles (Mayo Clinic) , Joseph J. Maleszewski (Mayo Clinic) , Johann Henckel (Royal National Orthopaedic Hospital) , Barry Sampson (Imperial College NHS Healthcare Trust) , Dominic B. Potter (University College London (UCL)) , Ibtisam Osman (Imperial College NHS Healthcare Trust) , Robert T. Trousdale (Mayo Clinic) , Alister Hart (University College London (UCL); Royal National Orthopaedic Hospital)
Co-authored by industrial partner: No

Type: Journal Paper
Journal: Journal Of Trace Elements In Medicine And Biology , VOL 46 , PAGES 128 - 137

State: Published (Approved)
Published: March 2018
Diamond Proposal Number(s): 15034

Abstract: Background: Orthopaedic implants made of cobalt-chromium alloy undergo wear and corrosion that can lead to deposition of cobalt and chromium in vital organs. Elevated cardiac tissue cobalt levels are associated with myocardial injury while chromium is a well-established genotoxin. Though metal composition of tissues surrounding hip implants has been established, few investigators attempted to characterize the metal deposits in systemic tissues of total joint arthroplasty patients. Methods: We report the first use of micro-X-ray fluorescence coupled with micro-X-ray absorption spectroscopy to probe distribution and chemical form of cobalt, chromium and titanium in postmortem samples of splenic, hepatic and cardiac tissue of patients with metal-on-polyethylene hip implants (n = 5). Results: Majority of the cobalt was in the 2+ oxidation state, while titanium was present exclusively as titanium dioxide, in either rutile or anatase crystal structure. Chromium was found in a range of forms including a highly oxidised, carcinogenic species (CrV/VI), which has never been identified in human tissue before. Conclusions: Carcinogenic forms of chromium might arise in vital organs of total joint arthroplasty patients. Further studies are warranted with patients with metal-on-metal implants, which tend to have an increased release of cobalt and chromium compared to metal-on-polyethylene hips.

Journal Keywords: CoChrome orthopaedic implant Cr(VI)

Subject Areas: Biology and Bio-materials

Instruments: I18-Microfocus Spectroscopy