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Prosthetic hip-associated cobalt toxicity.

Prosthetic hip-associated cobalt toxicity.

Journal of medical toxicology : official journal of the American College of Medical Toxicology (2013-11-22)

Anthony F Pizon, Michael Abesamis, Andrew M King, Nathan Menke

ABSTRACT

Prosthetic hip-associated cobalt toxicity (PHACT) is gaining recognition due to the use of metal-on-metal total hip replacements. Identifying true toxicity from merely elevated cobalt levels can be extremely difficult due to the lack of available data. An extensive review of the medical literature was undertaken to characterize cobalt toxicity from prosthetic hips. As an objective approach to making the diagnosis of PHACT, we suggest the following criteria: (1) elevated serum or whole blood cobalt levels due to a prosthetic hip, (2) at least two test-confirmed findings consistent with cobalt toxicity, and (3) exclusion of other etiologies. Adhering to objective diagnostic data for PHACT is a realistic and prudent method by which to eliminate the subjectivity of vague or difficult to identify complaints. These diagnostic criteria are not meant to evaluate prosthetic hardware failure, but as a means to identify systemic cobalt toxicity. Finally, assessment of cobalt toxicity from prosthetic hips should be done in conjunction with a medical toxicologist.

MATERIALS

Product Number

Brand

Product Description

Sigma-Aldrich

Cobalt, Carbon coated magnetic, nanopowder, <50 nm particle size (TEM), ≥99%

Sigma-Aldrich

Cobalt, powder, 2 μm particle size, 99.8% trace metals basis

Sigma-Aldrich

Cobalt, powder, <150 μm, ≥99.9% trace metals basis

Sigma-Aldrich

Cobalt, foil, thickness 1.0 mm, 99.95% trace metals basis

Sigma-Aldrich

Cobalt, foil, thickness 0.1 mm, 99.95% trace metals basis

Sigma-Aldrich

Cobalt, rod, diam. 5.0 mm, 99.95% trace metals basis

Sigma-Aldrich

Cobalt, foil, thickness 0.1 mm, ≥99.99%

Sigma-Aldrich

Cobalt, pieces, 99.5% trace metals basis

Sigma-Aldrich

Cobalt, wire, diam. 1.0 mm, 99.995% trace metals basis

Sigma-Aldrich

Cobalt, granular, 99.99% trace metals basis

Cobalt, foil, 8mm disks, thickness 0.009mm, 99.9%

Cobalt, foil, not light tested, 50x50mm, thickness 0.002mm, temporary acrylic support, 99.9%

Cobalt, foil, 8mm disks, thickness 0.01mm, 99.9%

Cobalt, foil, light tested, 25x25mm, thickness 0.009mm, 99.9%

Cobalt, foil, 6mm disks, thickness 0.125mm, as rolled, 99.99+%

Cobalt, foil, 8mm disks, thickness 0.005mm, 99.9%

Cobalt, foil, 8mm disks, thickness 0.0125mm, 99.9%

Cobalt, foil, 6mm disks, thickness 0.25mm, as rolled, 99.9%

Cobalt, foil, not light tested, 25x25mm, thickness 0.005mm, 99.9%

Cobalt, foil, 8mm disks, thickness 0.015mm, 99.9%

Cobalt, foil, 8mm disks, thickness 0.125mm, annealed, 99.9%

Cobalt, foil, not light tested, 50x50mm, thickness 0.006mm, 99.9%

Cobalt, microfoil, disks, 10mm, thinness 0.5μm, specific density 434μg/cm², permanent mylar 3.5μm support, 99.9%

Cobalt, foil, not light tested, 50x50mm, thickness 0.007mm, 99.9%

Cobalt, foil, not light tested, 150x150mm, thickness 0.0125mm, 99.9%

Cobalt, wire reel, 0.1m, diameter 1.0mm, hard, 99.99+%

Cobalt, foil, 8mm disks, thickness 0.003mm, 99.9%

Cobalt, foil, 8mm disks, thickness 0.25mm, as rolled, 99.99+%

Cobalt, foil, light tested, 50x50mm, thickness 0.01mm, 99.9%

Cobalt, foil, light tested, 25x25mm, thickness 0.0125mm, 99.9%