Wednesday, July 6, 2011

Development of hematopoietic cancers after implantation of total joint replacement.

Clin Orthop Relat Res. 1996 Aug;(329 Suppl):S290-6.

Gillespie WJ, Henry DA, O'Connell DL, Kendrick S, Juszczak E, McInneny K, Derby L.


Department of Orthopaedic Surgery, University of Edinburgh, Scotland.


The evidence from the 4 epidemiologic studies published before mid 1995, which have investigated the incidence of cancers in patients who have undergone joint implants, is conflicting. The results of the 2 earlier studies suggested a sustained increase in the risk of lymphoma and leukemia after total hip arthroplasty. The results of the 2 more recent studies have not confirmed this, although in 1 study an increased risk was observed in the first year after implantation. The heterogeneity may be statistical in origin, but could also have a biologic explanation in the greater proportion of metal on metal prostheses used before 1973. All 4 studies used national data as the comparison. Here, are presented the results of 2 matched cohort studies and a case control study set in North America and Scotland, and an overview of the 4 previous studies. Neither the results of the matched studies of patients operated on after 1973 nor the results of the latter 2 published studies suggest an increased risk of lymphoma or leukemia. If metal on metal articulations are reintroduced, careful surveillance is essential.

[ comments by connie:This study was interesting to me as it was a reference footnote from one of the key studies reviewed by the genotoxicity committee to come to its conclusions.  (You can see these studies under Medical studies on the blog landing medical studies and then go to the bottom of the page and look at 7a-7n.)  I have been searching for cancer test methodologies used in earlier studies.  I have found one of them from this reference which I will publish next....How have these studies tested for the T14'18 translocations in blood lymphocytes from patients with hip replacements???]

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