Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People's Republic of China.
Int J Nanomedicine. 2024 Jun 5;19:5245-5267. doi: 10.2147/IJN.S459255. eCollection 2024.
The development of metallic joint prostheses has been ongoing for more than a century alongside advancements in hip and knee arthroplasty. Among the materials utilized, the Cobalt-Chromium-Molybdenum (Co-Cr-Mo) and Titanium-Aluminum-Vanadium (Ti-Al-V) alloys are predominant in joint prosthesis construction, predominantly due to their commendable biocompatibility, mechanical strength, and corrosion resistance. Nonetheless, over time, the physical wear, electrochemical corrosion, and inflammation induced by these alloys that occur post-implantation can cause the release of various metallic components. The released metals can then flow and metabolize in vivo, subsequently causing potential local or systemic harm. This review first details joint prosthesis development and acknowledges the release of prosthetic metals. Second, we outline the metallic concentration, biodistribution, and elimination pathways of the released prosthetic metals. Lastly, we discuss the possible organ, cellular, critical biomolecules, and significant signaling pathway toxicities and adverse effects that arise from exposure to these metals.
金属关节假体的发展已经有一个多世纪的历史，伴随着髋关节和膝关节置换术的进步。在使用的材料中，钴铬钼（Co-Cr-Mo）和钛铝钒（Ti-Al-V）合金在关节假体的构建中占主导地位，主要是因为它们具有良好的生物相容性、机械强度和耐腐蚀性。然而，随着时间的推移，这些合金在植入后会发生物理磨损、电化学腐蚀和炎症，从而导致各种金属成分的释放。释放的金属随后可以在体内流动和代谢，从而可能导致局部或全身的伤害。本综述首先详细介绍了关节假体的发展，并承认了假体金属的释放。其次，我们概述了释放的假体金属的金属浓度、生物分布和消除途径。最后，我们讨论了暴露于这些金属可能引起的器官、细胞、关键生物分子和重要信号通路毒性和不良反应。
