Prosthetic Metals: Release, Metabolism and Toxicity

Abstract

Qiang Zhong,* Xin Pan,* Yuhang Chen, Qiang Lian, Jian Gao, Yixin Xu, Jian Wang, Zhanjun Shi, Hao Cheng Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhanjun Shi; Hao Cheng, Nanfang Hospital, Southern Medical University, 1838# Guangzhou North Avenue, Guangzhou, People’s Republic of China, Tel [phone], Email [email protected]; [email protected]: The development of metallic joint prostheses has been ongoing for more than a century alongside advancements in hip and knee arthroplasty. Among the materials utilized, the Cobalt-Chromium-Molybdenum (Co-Cr-Mo) and Titanium-Aluminum-Vanadium (Ti-Al-V) alloys are predominant in joint prosthesis construction, predominantly due to their commendable biocompatibility, mechanical strength, and corrosion resistance. Nonetheless, over time, the physical wear, electrochemical corrosion, and inflammation induced by these alloys that occur post-implantation can cause the release of various metallic components. The released metals can then flow and metabolize in vivo, subsequently causing potential local or systemic harm. This review first details joint prosthesis development and acknowledges the release of prosthetic metals. Second, we outline the metallic concentration, biodistribution, and elimination pathways of the released prosthetic metals. Lastly, we discuss the possible organ, cellular, critical biomolecules, and significant signaling pathway toxicities and adverse effects that arise from exposure to these metals. Keywords: metallic joint prostheses, prosthetic metal release, potential toxicity and adverse effects

Keywords

• metallic joint prostheses
• prosthetic metal release
• potential toxicity and adverse effects