Researchers Find Cause of Metal Hip Implant Inflammation

July 10, 2012 — Experts have known for years that the grinding parts of metal-on-metal hip implants can shed microscopic debris particles of cobalt and chromium. In some cases, these particles cause severe inflammation, pain, bone loss, and decreased mobility. However, until now, no one knew exactly how these nano-particles caused inflammation. Now, researchers have discovered that corroding chromium nano-particles release charged cobalt ions, which leach into the body and damage cellular DNA. The researchers were concerned about the long-term health complications of toxic chromium and cobalt in the body.

This research is the first to examine exactly what happens to metal nano-particles in the body. The researchers collaborated from Ohio State University and Imperial College London, and published their results in the journal Chemical Communication.

The researchers collected tissue samples from people who were undergoing revision surgery because their metal-on-metal hip implant was causing severe pain. Then, they utilized a novel approach to examine the tissues — high-resolution X-ray images and electron microscopes.

What they found was that the grinding metal-on-metal hip implants caused particles of chromium to shed. The metal debris accumulated in the spaces around the joint. Then the particles were absorbed by white blood cells, which normally clean up debris inside the body. Inside the cell, the chromium nano-particles were exposed to oxygen, which caused the chromium metal to oxidize and corrode. This released highly-soluble, charged ions of cobalt (Co²). The cobalt was easily absorbed into nearby tissues, while the chromium formed a metal residue.

The problem with Co² is that it is known to be genotoxic. It damages cellular DNA. Furthermore, chromium and cobalt nano-particles are not easily removed from the body even after the metal-on-metal hip implant is removed. This raises concerns about the potential long-term impact of metal nano-particles.

One co-author of the study, Dr. Mary Ryan, said:

“Even though a huge number of patients have benefited from replacement surgery, we still don’t fully understand the long-term impacts that implantable materials have on our bodies.”

The researchers said that they will continue studying the metal nano-particles. They wish to better understand why other metal alloys in metal-on-metal hip implants do not corrode as much as chromium or cobalt. Further research will also emphasize the long-term effects of metal nano-particles. The researchers plan to investigate the links between metal-on-metal hip implants and severe, life-threatening diseases such as Alzheimer’s disease.

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