Issues concerning possible cobalt-chromium carcinogenicity: a literature review and discussion.

Contemporary orthopaedics Pub Date : 1992-03-01
O L Berkenstock
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Abstract

Recently, questions have been raised concerning the stability and biocompatibility of metallic orthopaedic implants. Concerns have been expressed regarding cobalt-based alloys and the possibility of a future realization of a gross carcinogenic reaction from chrome-cobalt alloy implants. In this report, selected issues are reviewed and categorized for independent analysis to stimulate more comprehensive future research and theory formulation. Issues examined include those relating to metallic corrosion and potential local and systemic carcinogenic effects. The ionic valences of constituent materials, the electrochemical properties of the implant, and the proposed pathophysiological pathway of ions reportedly released from implants are traced. Tables listing 20 cases of primary neoplasia associated with total joint arthroplasty and seven cases reported in a 1975 study are discussed, compared, and contrasted. Finally, a selected bibliography is provided as a foundation for future study and research. In the author's opinion, the 50-year clinical experience and history of the use of cobalt-chromium as an implant material in orthopaedics, dentistry, and plastic surgery more than adequately establish its safety and effectiveness.

有关钴铬可能致癌性的问题:文献回顾与讨论。
近年来,人们对金属骨科植入物的稳定性和生物相容性提出了质疑。人们对钴基合金以及未来铬钴合金植入物产生严重致癌反应的可能性表示担忧。在本报告中,对选定的问题进行了回顾和分类,以进行独立分析,以激发更全面的未来研究和理论制定。审查的问题包括与金属腐蚀和潜在的局部和全身致癌作用有关的问题。本文追踪了组成材料的离子价,植入物的电化学性质,以及据报道从植入物中释放的离子的病理生理途径。表中列出了20例与全关节置换术相关的原发性肿瘤与1975年研究报告的7例病例进行了讨论、比较和对比。最后,为今后的学习和研究提供了参考书目。作者认为,在骨科、牙科和整形外科中使用钴铬作为植入材料的50年临床经验和历史足以证明其安全性和有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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