Neuropsychiatric symptoms following metal-on-metal implant failure with cobalt and chromium toxicity

Hdl Handle:
http://hdl.handle.net/10034/620321
Title:
Neuropsychiatric symptoms following metal-on-metal implant failure with cobalt and chromium toxicity
Authors:
Green, Ben ( 0000-0002-3934-3065 ) ; Griffiths, Emily; Almond, Solomon
Abstract:
Background: There were at least 31,171 metal-on-metal (MoM) hip implants in the UK between 2003 and 2011. Some of these were subject to failure and widescale recalls and revisions followed. Method This is a presentation of ten cases (mean age 60 years) where we evaluated neuropsychiatric morbidity following metal-on-metal hip implant failure and revision. Implants were ASR total hip replacement (acetabular implant, taper sleeve adaptor and unipolar femoral implants) performed between 2005 and 2009. This case series describes, for the first time, neuropsychiatric complications after revision where there has been cobalt and chromium toxicity. Results Pre-revision surgery, nine patients had toxic levels of chromium and cobalt (mean level chromium 338 nmol/l, mean cobalt 669.4 nmol/l). Depression assessment showed 9 of 9 respondents fulfilled the BDI criteria for depression and 3 of these were being treated. 7 of 9 patients showing short term memory deficit with mean mini mental state examination score of 24.2. The normal population mean MMSE for this group would be expected to be 28 with <25 indicating possible dementia. Conclusions We found neurocognitive and depressive deficits after cobalt and chromium metallosis following MoM implant failure. Larger studies of neurocognitive effects are indicated in this group. There may be implications for public health.
Affiliation:
University of Chester; Public Health England
Citation:
Green, B., Griffiths, E., & Almond, S. (2017). Neuropsychiatric symptoms following metal-on-metal implant failure with cobalt and chromium toxicity. BMC Psychiatry, 17(1), 33. DOI: 10.1186/s12888-016-1174-1
Publisher:
BioMed Central
Journal:
BMC Psychiatry
Publication Date:
24-Jan-2017
URI:
http://hdl.handle.net/10034/620321
DOI:
10.1186/s12888-016-1174-1
Additional Links:
http://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-016-1174-1
Type:
Article
Language:
en
EISSN:
1471-244X
Appears in Collections:
Gold OA; Institute of Medicine

Full metadata record

DC FieldValue Language
dc.contributor.authorGreen, Benen
dc.contributor.authorGriffiths, Emilyen
dc.contributor.authorAlmond, Solomonen
dc.date.accessioned2017-01-24T12:52:21Z-
dc.date.available2017-01-24T12:52:21Z-
dc.date.issued2017-01-24-
dc.identifier.citationGreen, B., Griffiths, E., & Almond, S. (2017). Neuropsychiatric symptoms following metal-on-metal implant failure with cobalt and chromium toxicity. BMC Psychiatry, 17(1), 33. DOI: 10.1186/s12888-016-1174-1en
dc.identifier.doi10.1186/s12888-016-1174-1-
dc.identifier.urihttp://hdl.handle.net/10034/620321-
dc.description.abstractBackground: There were at least 31,171 metal-on-metal (MoM) hip implants in the UK between 2003 and 2011. Some of these were subject to failure and widescale recalls and revisions followed. Method This is a presentation of ten cases (mean age 60 years) where we evaluated neuropsychiatric morbidity following metal-on-metal hip implant failure and revision. Implants were ASR total hip replacement (acetabular implant, taper sleeve adaptor and unipolar femoral implants) performed between 2005 and 2009. This case series describes, for the first time, neuropsychiatric complications after revision where there has been cobalt and chromium toxicity. Results Pre-revision surgery, nine patients had toxic levels of chromium and cobalt (mean level chromium 338 nmol/l, mean cobalt 669.4 nmol/l). Depression assessment showed 9 of 9 respondents fulfilled the BDI criteria for depression and 3 of these were being treated. 7 of 9 patients showing short term memory deficit with mean mini mental state examination score of 24.2. The normal population mean MMSE for this group would be expected to be 28 with <25 indicating possible dementia. Conclusions We found neurocognitive and depressive deficits after cobalt and chromium metallosis following MoM implant failure. Larger studies of neurocognitive effects are indicated in this group. There may be implications for public health.en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-016-1174-1en
dc.subjectHip implanten
dc.subjectCobalten
dc.subjectChromiumen
dc.subjectDepressionen
dc.subjectCognitiveen
dc.subjectNeuropsychiatricen
dc.subjectMetal-on-metalen
dc.titleNeuropsychiatric symptoms following metal-on-metal implant failure with cobalt and chromium toxicityen
dc.typeArticleen
dc.identifier.eissn1471-244X-
dc.contributor.departmentUniversity of Chester; Public Health Englanden
dc.identifier.journalBMC Psychiatryen
dc.language.rfc3066en-
dc.rights.holderThe Author(s).-
dc.date.updated2017-01-24T07:02:03Z-
dc.date.accepted2017-12-22-
or.grant.openaccessYesen
rioxxterms.funderUnfundeden
rioxxterms.identifier.projectUnfundeden
rioxxterms.versionVoRen
rioxxterms.licenseref.startdate2017-01-24-
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