JAMA Netw Open

Elevated metal levels found in patients with joint implants

April 1, 2025

Metal ions from arthroplasty implants have the potential to cross neural barriers and accumulate in the cerebrospinal fluid (CSF), particularly cobalt. Given the neurotoxic effects of cobalt, findings from this study underscore the need for further research to determine the clinical significance of these metal concentrations and their potential link to neurological dysfunction in patients with joint replacements.

Study details: The NeuroWear pilot study, a single-site, hospital-based cross-sectional study conducted between 2018 and 2019, compared metal concentrations in CSF, whole blood, and serum of 204 patients in Germany, half of whom had large joint replacements.

Results: Patients with arthroplasty implants had significantly higher median cobalt levels in CSF (0.03 μg/L) compared with controls (0.02 μg/L). Cobalt levels in CSF were strongly correlated with serum (r = 0.72; 95% confidence interval [CI], 0.53-0.85)) and whole blood (r = 0.82; 95% CI, 0.62-0.92) levels. Additionally, patients with implants had elevated levels of chromium, titanium, niobium, and zirconium in both blood and CSF. Notably, those with cobalt-chromium-molybdenum components exhibited higher CSF chromium levels than control participants (0.31 μg/L vs. 0.23 μg/L).

Source:

Rakow A, et al. (2025, March 3). JAMA Netw Open. Metal Concentrations in Blood and Cerebrospinal Fluid of Patients With Arthroplasty Implants. http://pubmed.ncbi.nlm.nih.gov/40152863/