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Metallosis: what is it?

Discussion in 'LIBRARY Scientific Articles' started by Josephine, Oct 27, 2010.

  1. Josephine

    Josephine NURSE DIRECTOR, BONESMART Administrator

    Member Since:
    Jun 8, 2007
    The North
    United Kingdom United Kingdom
    From SpineUniversity

    Metallosis is the result of the body reacting to a metal implant. The immune system sees this device as foreign. It mounts a defense against the prosthesis (implant) and tries to rid itself of it. Inflammation and scarring around the implant are the result.
    Any time there is a metal-on-metal articulation, tiny flecks of metal are shaved off and released into the area. It also produces tiny particles called metal ions which human tissue doesn't much care for. Such metal ions set up a foreign-body reaction where the body's immune system, special white blood cells called macrophages, attack the area in an attempt to rid the body of the foreign substance. In the process, bone and soft tissue can be destroyed as the body tries to respond to the metal ions. The ultimate result can be failure of the implant from loosening of the device where the bone has been destroyed.
    Fracture, infection, or loosening of the implant usually requires a second surgery where the prosthesis is replaced with a different type.
    Vincenzo Denaro, MD, PhD, et al. Periprosthetic Electrochemical Corrosion of Titanium and Titanium-Based Alloys as a Cause of Spinal Fusion Failure. In Spine. January 2008. Vol. 33. No. 1. Pp. 8-13.

    Also from the Stryker site

    Many people who have received metal-on-metal hip replacement implants are wary of physical symptoms of device failure, such as pain, swelling and reduced mobility. Unfortunately, there can be other symptoms of hip implant failure that might not be as obvious. Another serious indication of failure could be metallosis, which is characterized by dangerously elevated levels of chromium and cobalt in the blood. This can be caused by the shedding of microscopic particles from all-metal hip replacements.

    How Do I Know If I Have Metallosis?

    Unfortunately, metallosis cannot be detected without a visit to the doctor to undergo a blood test. Recipients of all-metal hips, such as the Stryker Trident, Rejuvenate and ABG II implants are often advised to undergo regular screening for metallosis, even if they are not yet experiencing physical symptoms of failure. There are however, some symptoms associated with metallosis, and those can include:
    • Inflammation
    • Infection
    • Immobility
    • Joint stiffness
    • Lack of range of motion
    • Tinnitus
    • Vertigo
    • Blindness
    • Deafness
    • Peripheral neuropathy
    • Headaches
    • Optic nerve atrophy
    • Convulsions
    • Cardiomyopathy
    • Hypothyroidism
    The symptoms listed can also lead to more serious side effects including some cancers, and damage to the body’s internal organs. Many recipients who have had to undergo revision surgery to remove and replace as Stryker all-metal hip implant, have had symptoms of metallosis in addition to other symptoms of device failure.
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