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Title: The indirect cytogenetic effects of orthopaedic wear debris generated by modern metal on metal hip implants
Author: Parry, Michael Christopher
ISNI:       0000 0004 2725 2208
Awarding Body: University of Bristol
Current Institution: University of Bristol
Date of Award: 2011
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Total hip replacement is an effective treatment for arthritis of the hip. Its use has expanded to include younger patients with higher functional demands resulting in poor implant survival when conventional arthroplasty designs are employed. This has resulted in the development of alternative bearing materials and designs including resurfacing arthroplasties. The effects of particulate and ionic debris generated by these bearings have recently come to light. Metal alloys including cobalt chromium are often employed as bearings in young patients and are associated with genotoxic and teratogenic effects. The potential for this debris to cause damage to the foetus of a mother with a metal implant is a cause for concern. This risk is difficult to assess using epidemiological methods. The aim of this study was to investigate factors associated with an increase in metal levels in the blood and urine of patients undergoing resurfacing arthroplasty. We aimed to investigate the potential for debris generated by metal hip replacements to cause chromosomal aberrations in the foetus. To do this, we employed an in vitro cellular barrier to investigate the transport of material across the human placenta, and human fibroblasts and embryonic stem cells to record the effect. Nanoparticles of cobalt chrome but not ceramic or ionic cobalt and chromium, induced chromosomal aberrations, the majority of which were tetraploidy. When indirectly exposed to human embryonic stem cells, nanoparticles of cobalt chrome resulted in DNA damage only when exposed to differentiated cells. Metallic debris indirectly induces chromosomal aberrations in human cells, depending on the nature of the material and its surface characteristics. The foetus is most susceptible to damage at the time of differentiation. These results raise further concerns about the use of metallic bearings in women of child bearing age.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available