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Sun CWY, Lau LCM, Cheung JPY, Choi SW. Cancer-Causing Effects of Orthopaedic Metal Implants in Total Hip Arthroplasty. Cancers (Basel) 2024; 16:1339. [PMID: 38611017 PMCID: PMC11011042 DOI: 10.3390/cancers16071339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Metal implants have been preferentially used in THA due to its biocompatibility, mechanical stability and durability. Yet concerns have emerged regarding their potential to release metallic ions, leading to long-term adverse effects, including carcinogenicity. This study aimed to investigate the risk of cancer development in patients with orthopaedic metal implants in total hip arthroplasty (THA). METHODS Patients with THA conducted at a local tertiary implant centre from 2001-2008 were linked to the local cancer registry and followed up to the end of 2023. Standardized incidence ratios (SIRs) for cancer incidence and its confidence interval by Poisson distribution were calculated. Survival analysis was depicted using the Kaplan-Meier method, and the log-rank test was used to assess the differences across groups. RESULTS The study cohort included 388 patients and 53 cancers diagnosed during follow-up, at least 5 years post THA. All-site cancer risks were increased in patients with THA (SIR: 1.97; 95% CI: 1.48-2.46), validated with chi-square analysis (chi-square = 15.2551, N = 100,388, p < 0.01). A statistically significant increase in multiple site-specific cancers including haematological cancers were identified. CONCLUSIONS Patients with THA were found to have an increased risk for cancer compared to the general population during a mean follow-up of 16 years.
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Affiliation(s)
| | | | | | - Siu-Wai Choi
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (C.W.Y.S.); (L.C.M.L.); (J.P.Y.C.)
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Singh RG, Lyons KM, Waddell JN, Li KC. Effect of thermocycling on the mechanical properties, inorganic particle release and low temperature degradation of glazed high translucent monolithic 3Y-TZP dental restorations. J Mech Behav Biomed Mater 2022; 136:105495. [PMID: 36208582 DOI: 10.1016/j.jmbbm.2022.105495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/27/2022] [Accepted: 09/27/2022] [Indexed: 11/24/2022]
Abstract
The influence of thermocycling on the surface deterioration of glazed monolithic high translucent 3Y-TZP dental restorations is still unclear. The purpose of this study therefore was to evaluate low temperature degradation (LTD), elemental release and surface degradation pattern after five years of simulated clinical time. A total of 123 specimens were prepared from second-generation high translucent 3Y-TZP as per ISO 6872:2015 standards (3 mm × 4 mm × 30 mm). They were classified as per glazing and thermocycling protocol; group CPT, DGT and IGT. Glaze materials were applied on one surface of the specimen and subjected to a thermocycling in artificial saliva, four-point bending test, inductively coupled plasma mass spectrometry (ICP-MS), scanning electron microscopy (SEM), energy dispersive x-ray spectroscopy (EDX) and x-ray diffraction (XRD). Flexural strength, characteristic strength and Weibull modulus values were derived from four-point bending test. Descriptive fractographic analysis of surfaces was conducted to observe the surface degradation characteristics and point of failure. Control/no glaze with thermocycling (CPT = 621.5, 1σ = 117.0 MPa) presented higher flexural strength values compared to glaze I with thermocycling (442.4, 1σ = 45.4 MPa) and glaze II with thermocycling (534.3, 1σ = 46.3 MPa). Characteristic strength from Weibull analysis also observed higher values (669.2 MPa) for the control specimens. XRD analysis showed that monoclinic volume fraction (Vm = 11.0, 1σ = 0.7%) was highest in control specimens. Fractographic analysis suggested that there was no correlation between the point of failure initiation and mean flexural strength values. Glazing protected the high translucent 3Y-TZP surface against LTD during thermocycling but negatively impacted on the flexural strength.
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Affiliation(s)
- Raj Gaurav Singh
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, New Zealand.
| | - Karl Michael Lyons
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, New Zealand.
| | - John Neil Waddell
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, New Zealand.
| | - Kai Chun Li
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, New Zealand.
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Jamari J, Ammarullah MI, Santoso G, Sugiharto S, Supriyono T, Prakoso AT, Basri H, van der Heide E. Computational Contact Pressure Prediction of CoCrMo, SS 316L and Ti6Al4V Femoral Head against UHMWPE Acetabular Cup under Gait Cycle. J Funct Biomater 2022; 13:jfb13020064. [PMID: 35645272 PMCID: PMC9149981 DOI: 10.3390/jfb13020064] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 12/12/2022] Open
Abstract
Due to various concerns about the use of metal-on-metal that is detrimental to users, the use of metal as acetabular cup material was later changed to ultra high molecular weight polyethylene (UHMWPE). However, the wear on UHMWPE releases polyethylene wear particles, which can trigger a negative body response and contribute to osteolysis. For reducing the wear of polyethylene, one of the efforts is to investigate the selection of metal materials. Cobalt chromium molybdenum (CoCrMo), stainless steel 316L (SS 316L), and titanium alloy (Ti6Al4V) are the frequently employed materials. The computational evaluation of contact pressure was carried out using a two-dimensional axisymmetric model for UHMWPE acetabular cup paired with metal femoral head under gait cycle in this study. The results show Ti6Al4V-on-UHMWPE is able to reduce cumulative contact pressure compared to SS 316L-on-UHMWPE and CoCrMo-on-UHMWPE. Compared to Ti6Al4V-on-UHMWPE at peak loading, the difference in cumulative contact pressure to respective maximum contact pressure is 9.740% for SS 316L-on-UHMWPE and 11.038% for CoCrMo-on-UHMWPE.
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Affiliation(s)
- J. Jamari
- Department of Mechanical Engineering, Faculty of Engineering, Diponegoro University, Semarang 50275, Central Java, Indonesia;
- Undip Biomechanics Engineering & Research Centre (UBM-ERC), Diponegoro University, Semarang 50275, Central Java, Indonesia
| | - Muhammad Imam Ammarullah
- Undip Biomechanics Engineering & Research Centre (UBM-ERC), Diponegoro University, Semarang 50275, Central Java, Indonesia
- Department of Mechanical Engineering, Faculty of Engineering, Pasundan University, Bandung 40264, West Java, Indonesia; (G.S.); (S.S.); (T.S.)
- Correspondence: ; Tel.: +62-895-3559-22435
| | - Gatot Santoso
- Department of Mechanical Engineering, Faculty of Engineering, Pasundan University, Bandung 40264, West Java, Indonesia; (G.S.); (S.S.); (T.S.)
| | - S. Sugiharto
- Department of Mechanical Engineering, Faculty of Engineering, Pasundan University, Bandung 40264, West Java, Indonesia; (G.S.); (S.S.); (T.S.)
| | - Toto Supriyono
- Department of Mechanical Engineering, Faculty of Engineering, Pasundan University, Bandung 40264, West Java, Indonesia; (G.S.); (S.S.); (T.S.)
| | - Akbar Teguh Prakoso
- Department of Mechanical Engineering, Faculty of Engineering, Sriwijaya University, Indralaya 30662, South Sumatra, Indonesia; (A.T.P.); (H.B.)
| | - Hasan Basri
- Department of Mechanical Engineering, Faculty of Engineering, Sriwijaya University, Indralaya 30662, South Sumatra, Indonesia; (A.T.P.); (H.B.)
| | - Emile van der Heide
- Laboratory for Surface Technology and Tribology, Faculty of Engineering Technology, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands;
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Wang X, An P, Gu Z, Luo Y, Luo J. Mitochondrial Metal Ion Transport in Cell Metabolism and Disease. Int J Mol Sci 2021; 22:ijms22147525. [PMID: 34299144 PMCID: PMC8305404 DOI: 10.3390/ijms22147525] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/06/2021] [Accepted: 07/13/2021] [Indexed: 12/19/2022] Open
Abstract
Mitochondria are vital to life and provide biological energy for other organelles and cell physiological processes. On the mitochondrial double layer membrane, there are a variety of channels and transporters to transport different metal ions, such as Ca2+, K+, Na+, Mg2+, Zn2+ and Fe2+/Fe3+. Emerging evidence in recent years has shown that the metal ion transport is essential for mitochondrial function and cellular metabolism, including oxidative phosphorylation (OXPHOS), ATP production, mitochondrial integrity, mitochondrial volume, enzyme activity, signal transduction, proliferation and apoptosis. The homeostasis of mitochondrial metal ions plays an important role in maintaining mitochondria and cell functions and regulating multiple diseases. In particular, channels and transporters for transporting mitochondrial metal ions are very critical, which can be used as potential targets to treat neurodegeneration, cardiovascular diseases, cancer, diabetes and other metabolic diseases. This review summarizes the current research on several types of mitochondrial metal ion channels/transporters and their functions in cell metabolism and diseases, providing strong evidence and therapeutic strategies for further insights into related diseases.
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Affiliation(s)
- Xuan Wang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100193, China; (X.W.); (P.A.)
| | - Peng An
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100193, China; (X.W.); (P.A.)
| | - Zhenglong Gu
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA;
| | - Yongting Luo
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100193, China; (X.W.); (P.A.)
- Correspondence: (Y.L.); (J.L.)
| | - Junjie Luo
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100193, China; (X.W.); (P.A.)
- Correspondence: (Y.L.); (J.L.)
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Course of Metal Ions after a Revision of Malfunctioning Metal-on-Metal Total Hip Prostheses. ACTA ACUST UNITED AC 2021; 57:medicina57020115. [PMID: 33525335 PMCID: PMC7912175 DOI: 10.3390/medicina57020115] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 12/16/2022]
Abstract
The present research evaluated the course of cobalt and chromium in the blood and urine after the revision of metal-on-metal with a ceramic-on-polyethylene total hip arthroplasty. Seven patients were enrolled for hip prosthesis revision owing to ascertained damage of the implant. Metals in the blood and urine were evaluated before and after the hip revision. The double measurement before the total hip revision revealed high levels of metal ions (on average, 88.1 µg/L of cobalt in the blood, 399.0 µg/g of creatinine cobalt in the urine, 46.8 µg/L of chromium in the blood, and 129.6 µg/g of creatinine chromium in the urine at the first measurements), with an increasing trend between the first and second dosage. Within a week after the hip revision, the levels of metal ions significantly decreased by approximately half. Four to six months after the operation, the cobalt levels were found near to the reference values, whereas the chromium levels reached 25% of the values measured before the revision. The revision of malfunctioning metal-on-metal implants produced a dramatic decrease of metal ions in biological fluids, although it did not completely rescue the chromium level.
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