The in vitro toxicity of cobalt-chrome-molybdenum alloy and its constituent metals.

Cobalt-chrome-molybdenum alloys are widely used in orthopaedic implants. Although they are relatively well tolerated, complications (including loosening and tissue necrosis) still occur and sometimes appear to be due to incomplete biocompatibility of the alloy. To investigate the local effect of the alloy on cells derived from the musculo-skeletal system, primary lines of fibroblastic cells from newborn rats were exposed to powders of cobalt-chrome-molybdenum alloy and its main constituents cobalt, chromium nickel and molybdenum. The toxicity of the metals was determined by counts of total cell number and of abnormal cells at intervals from 2 to 12 d. The alloy was much less toxic than cobalt or nickel and the pattern of toxicity was different for each metal. The results emphasize the difficulty of devising a single tissue culture test of toxicity which will measure the toxicity of any potential implant material.