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In Vitro Analyses of the Toxicity, Immunological, and Gene Expression Effects of Cobalt-Chromium Alloy Wear Debris and Co Ions Derived from Metal-on-Metal Hip Implants

Biomedical Engineering Department, University of Strathclyde, Wolfson Centre, Glasgow G4 0NW, UK
Strathclyde Institute for Pharmacy & Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
Department of Orthopaedic Surgery, Southern General Hospital, Glasgow G11 6NT, UK
Current affiliation, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds LS2 9JT, UK
Author to whom correspondence should be addressed.
Academic Editor: J. Philippe Kretzer
Lubricants 2015, 3(3), 539-568;
Received: 30 April 2015 / Revised: 12 June 2015 / Accepted: 8 July 2015 / Published: 14 July 2015
(This article belongs to the Special Issue Tribological Performance of Artificial Joints)
PDF [346 KB, uploaded 14 July 2015]


Joint replacement has proven to be an extremely successful and cost-effective means of relieving arthritic pain and improving quality of life for recipients. Wear debris-induced osteolysis is, however, a major limitation and causes orthopaedic implant aseptic loosening, and various cell types including macrophages, monocytes, osteoblasts, and osteoclasts, are involved. During the last few years, there has been increasing concern about metal-on-metal (MoM) hip replacements regarding adverse reactions to metal debris associated with the MoM articulation. Even though MoM-bearing technology was initially aimed to extend the durability of hip replacements and to reduce the requirement for revision, they have been reported to release at least three times more cobalt and chromium ions than metal-on-polyethylene (MoP) hip replacements. As a result, the toxicity of metal particles and ions produced by bearing surfaces, both locally in the periprosthetic space and systemically, became a concern. Several investigations have been carried out to understand the mechanisms responsible for the adverse response to metal wear debris. This review aims at summarising in vitro analyses of the toxicity, immunological, and gene expression effects of cobalt ions and wear debris derived from MoM hip implants. View Full-Text
Keywords: wear debris; cobalt; metal-on-metal; hip implants wear debris; cobalt; metal-on-metal; hip implants

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Posada, O.M.; Tate, R.J.; Meek, R.D.; Grant, M.H. In Vitro Analyses of the Toxicity, Immunological, and Gene Expression Effects of Cobalt-Chromium Alloy Wear Debris and Co Ions Derived from Metal-on-Metal Hip Implants. Lubricants 2015, 3, 539-568.

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