ReviewEFORT open reviews2022
Prosthetic hip-associated cobalt toxicity: a systematic review of case series and case reports.
Review in EFORT open reviews, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Mandatory Labelling of CMR Substances in Implants and Their Impact on Orthopedics and Trauma Surgery.Zeitschrift fur Orthopadie und Unfallchirurgie · 2026Pooled it
- Knee arthroplasty failure is associated with significant systemic multimetal exposure.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Neural impairments caused by energy storage material NCM811 via aberrated synaptic pruning: role of Th17 cells in microglia polarization.Journal of neuroinflammation · 2026Article
- Exploring the interactions between curcumin and cobalt: implications for health and toxicity.Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2026Review
- Kinetics and Fluid-Specific Behavior of Metal Ions After Hip Replacement.Bioengineering (Basel, Switzerland) · 2025Article
- Navigating Transition Metal-Dependent Cell Death: Mechanisms, Crosstalk, and Future Directions.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Review
- Selenium nanoparticles alleviate cobalt toxicity in artificial joint metal prostheses by inhibiting ferroptosis through activation of the PRDX6/GPX4 pathway.Materials today. Bio · 2025Article
- Outcomes following primary total hip arthroplasty with ceramic-on-metal and metal-on-metal bearings.Archives of orthopaedic and trauma surgery · 2025Observational
- Cobalt-induced Retinopathy: Unveiling the hidden risk of knee prosthesis.American journal of ophthalmology case reports · 2025Article
- Sarcoidosis Induced by Metal Particles From a Left Elbow Prosthesis.Kidney medicine · 2025Article
- The Association of Blood Cobalt Levels with Cardiovascular and Chronic Kidney Diseases: Mediating Role of Inflammatory Indicators (SII, NLR, PLR, NMLR, and LMR).Cardiovascular toxicology · 2025Article
- Cardiac Tamponade and Pneumonitis as Indicators of Systemic Cobaltosis in Metal-on-Polyethylene Hip Implants.The American journal of case reports · 2025Article
- Trace elements: Clinical perspectives in the critically ill.Journal of the Intensive Care Society · 2025Review
- Metal Concentrations in Blood and Cerebrospinal Fluid of Patients With Arthroplasty Implants.JAMA network open · 2025Article
- Article
- Multifunctional Hybrid Material for Endoprosthetic Implants Based on Alumina-Toughened Zirconia Ceramics and Additively Manufactured TiNbTa Alloys.Materials (Basel, Switzerland) · 2024Article
- Influence of Physical Activity and Cup Orientation on Metal Ion Release and Oxidative Stress in Metal-on-Metal and Ceramic-on-Metal Total Hip Arthroplasty.Journal of clinical medicine · 2024Article
- Systemic Cobalt Toxicity Secondary to Metal-on-Metal Prosthetic Hip Replacement: a Case Report.Journal of general internal medicine · 2024Article
- Ceramic fragmentation after total hip arthroplasty: two case reports and literature review.Frontiers in surgery · 2024Article
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Prosthetic hip-associated cobalt toxicity (PHACT) is caused by elevated blood cobalt concentrations after hip arthroplasty. The aim of this study is to determine which symptoms are reported most frequently and in what type of bearing. We also try to determine the blood level of cobalt concentrations associated with toxicological symptoms. A systematic review was conducted on the 10th of July according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A methodological quality assessment (risk of bias (RoB)) was performed. Primary outcomes were the reported symptoms of cobalt toxicity and the level of cobalt concentrations in blood. These levels were associated with toxicological symptoms. A total of 7645 references were found of which 67 relevant reports describing 79 patients. The two most used bearings in which PHACT was described were metal-on-metal (MoM) bearings (38 cases) and revised (fractured) ceramic-on-ceramic (CoC) bearings where the former ceramic head was replaced by a metal head (32 cases). Of all reported symptoms, most were seen in the neurological system, of which 24% were in the sensory system and 19.3% were in central/peripheral system, followed by the cardiovascular (22.1%) system. The mean cobalt concentration for MoM-bearings was 123.7 ± 96.8 ppb and 1078.2 ± 1267.5 ppb for the revised fractured CoC-bearings. We recommend not to use a metal-based articulation in the revision of a fractured CoC bearing and suggest close follow-up with yearly blood cobalt concentration controls in patients with a MoM bearing or a revised fractured CoC bearing. Level of Evidence: Level V, systematic review.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.