Saturday, July 2, 2011

Systemic effects of metal debris (7L of 7); excerpts from the Committee on Mutagenicity

Excerpts and commentary based on the 6/4 post-Metal on Metal Bearings, The Evidence So Far

Genotoxic issues surrounding systemic effects of metal debris (continued from prior posts)

The committee on mutagenicity has reported that internal exposure to orthopedic metals is associated with increased genotoxicity.

This is a series of commentary from the committee on mutangenicity evidence based on the the key journal articles examined by that committee. I think you will find the results really interesting if you are concerned about the systemic effects of the metal.

I said this would be the last in this series however, there seem to be 6 items provided in confidence and I am going to try to locate the source data (more time so I myself would like to take time to review each one daily.

6th and final group of comments from the committee (In confidence data sumbitted by the BIRC)...[6 individual comments provided.. 6-11] 

4 of 6  (Important!)

Post-Mortem histological evaluations had shown widespread metal debris in individuals with SS (stainless steel) and Co-Cr implants which could be detected even when there was no apparent ware of the replacement hip.  metal debris was detected in both local and distant lymph nodes, bone marrow, liver and spleen!!!

J Bone Joint Surg Br. 1994 Sep;76(5):701-12.

Widespread dissemination of metal debris from implants.


Southmead Hospital, England.


In a post-mortem study, we compared subjects with metal implants with and without visible wear with an age-matched control group to determine the extent and effects of dissemination of wear debris. In subjects with stainless-steel and cobalt-chrome prostheses metal was found in local and distant lymph nodes, bone marrow, liver and spleen. The levels were highest in subjects with loose, worn joint prostheses and the main source of the debris was the matt coating. Metal levels were also raised in subjects with implants without visible wear and, to a less extent, in those with dynamic hip screws. Necrosis of lymph nodes was seen in those cases with the most wear, and potential damage to more distant organs such as the bone marrow, liver and spleen in the long term cannot be discounted. The consequences for the immune system and the role of metal dissemination in the possible induction of neoplasia are discussed. [I need to review this study in more detail later.]

[Neoplasm is an abnormal mass of tissue as a result of neoplasia. Neoplasia ("new growth" in Greek) is the abnormal proliferation of cells. The growth of neoplastic cells exceeds and is not coordinated with that of the normal tissues around it. The growth persists in the same excessive manner even after cessation of the stimuli. It usually causes a lump or tumor. Neoplasms may be benign, pre-malignant (carcinoma in situ) or malignant (cancer).]

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