Patients with metal joint replacements may have significantly higher concentrations of cobalt, chromium, titanium, niobium and zirconium in their blood and cerebrospinal fluid, according to a March 28 study published in JAMA Network Open.
The study compared 204 patients, including 118 women and 86 men with a median age of 69.4, with large joint replacements to control patients with no arthroplasty.
While several of the metals were not significantly higher in arthroplasty patients, cobalt was found in high concentrations.
Here are the median levels of metals in the blood of arthroplasty patients versus control patients in micrograms per liter:
Cobalt: 0.27 patients, 0.16 controls
Chromium: 0.47 patients, 0.42 controls
Titanium: 8.05 patients, 7.15 controls
Niobium: 0.02 patients, 0.01 controls
Zirconium: 0.05 patients, 0.03 controls
Cobalt is known to be a toxic metal, while titanium, niobium, chromium and aluminum can cause harm to neural tissues.
“Several case reports and series linked systemic arthroprosthetic cobalt exposure to significant cardiac, thyroid, and/or neurological dysfunction and rare experimental studies and analyses of arthroplasty registries focused on the potential immunotoxic effects, cancerogenicity, and teratogenicity of cobalt and chromium species,” the study authors wrote.
