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BMC Psychiatry

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Open Access 01-12-2017 | Research article

Neuropsychiatric symptoms following metal-on-metal implant failure with cobalt and chromium toxicity

Authors: Ben Green, Emily Griffiths, Solomon Almond

Published in: BMC Psychiatry | Issue 1/2017

Abstract

Background

There were at least 31,171 metal-on-metal (MoM) hip implants in the UK between 2003 and 2011. Some of these were subject to failure and widescale recalls and revisions followed.

Method

This is a presentation of ten cases (mean age 60 years) where we evaluated neuropsychiatric morbidity following metal-on-metal hip implant failure and revision. Implants were ASR total hip replacement (acetabular implant, taper sleeve adaptor and unipolar femoral implants) performed between 2005 and 2009. This case series describes, for the first time, neuropsychiatric complications after revision where there has been cobalt and chromium toxicity.

Results

Pre-revision surgery, nine patients had toxic levels of chromium and cobalt (mean level chromium 338 nmol/l, mean cobalt 669.4 nmol/l). Depression assessment showed 9 of 9 respondents fulfilled the BDI criteria for depression and 3 of these were being treated. 7 of 9 patients showing short term memory deficit with mean mini mental state examination score of 24.2. The normal population mean MMSE for this group would be expected to be 28 with <25 indicating possible dementia.

Conclusions

We found neurocognitive and depressive deficits after cobalt and chromium metallosis following MoM implant failure. Larger studies of neurocognitive effects are indicated in this group. There may be implications for public health.

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Title: Neuropsychiatric symptoms following metal-on-metal implant failure with cobalt and chromium toxicity
Authors: Ben Green
Emily Griffiths
Solomon Almond
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-016-1174-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Neuropsychiatric symptoms following metal-on-metal implant failure with cobalt and chromium toxicity

Abstract

Background

Method

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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