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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 10, 1439-1444.
doi: 10.1302/0301-620X.87B10.16541  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Metal-specific differences in levels of DNA damage caused by synovial fluid recovered at revision arthroplasty

A. P. Davies, BSc, MD, FRCS(Orth), SpR Trauma & Orthopaedics1; A. Sood, BSc, Postgraduate Researcher1; A. C. Lewis, BMus, PhD, Research Assistant1; R. Newson, MSc, DPhil, Lecturer in Medical Statistics2; I. D. Learmonth, FRCS(Ed), FCS(SA)Orth, Professor of Orthopaedic Surgery1; and C. P. Case, DPhil, FRCPath, Consultant Senior Lecturer in Orthopaedics with Pathology1

1 Bristol Implant Research Centre, Southmead Hospital, Bristol BS10 5NB, UK.
2 Department of Public Health Sciences, King’s College Hospital, Capital House, 42 Weston Street, London SE1 3QD, UK.

Correspondence should be sent to Mr A. P. Davies; e-mail: andypdavies{at}hotmail.com

Previous research has shown an increase in chromosomal aberrations in patients with worn implants. The type of aberration depended on the type of metal alloy in the prosthesis. We have investigated the metal-specific difference in the level of DNA damage (DNA stand breaks and alkali labile sites) induced by culturing human fibroblasts in synovial fluid retrieved at revision arthroplasty.

All six samples from revision cobalt-chromium metal-on-metal and four of six samples from cobalt-chromium metal-on-polyethylene prostheses caused DNA damage. By contrast, none of six samples from revision stainless-steel metal-on-polyethylene prostheses caused significant damage. Samples of cobalt-chromium alloy left to corrode in phosphate-buffered saline also caused DNA damage and this depended on a synergistic effect between the cobalt and chromium ions.

Our results further emphasise that epidemiological studies of orthopaedic implants should take account of the type of metal alloy used.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General