The local and systemic effects of cobalt- chromium nanoparticles on the human body: The implications for metal-on-metal hip arthroplasty

Abstract

Prostheses made from metal alloys have been successfully utilised within medicine for hundreds of years. Among these, cobalt-chromium (Co-Cr) alloys have seen extensive use in orthopaedic applications, including hip and knee joint replacements. Despite all the research and development that has gone into optimising these implants, however, a small proportion of them ultimately fail and require revision after a number of years. While the reasons for this are diverse, the reaction of metal nanoparticles to human tissues is a recognised complication of implanting these alloys within the body. This chapter explores the orthopaedic use of metal alloys within the human body as well as the local and systemic effects of these metal nanoparticles, with emphasis on large-diameter metal-on-metal hip replacements.