Significance of Elevated Blood Metal Ion Levels in Patients with Metal-on-Metal Prostheses: An Evaluation of Oxidative Stress Markers

Cathy Tkaczyk1, Alain Petit2, John Antoniou2, David J Zukor2, Maryam Tabrizian1, Olga L Huk*, 2
1 Department of Biomedical Engineering, McGill University, Duff Medical Building, 3775 University Street, Montreal, Quebec, H3A 2B4, Canada
2 Division of Orthopaedic Surgery, McGill University and Lady Davis Institute for Medical Research, SMBD-Jewish General Hospital, 3755 Chemin de la Côte Ste-Catherine, Montreal, Quebec, H3T 1E2, Canada

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© Tkaczyk et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the SMBD-Jewish General Hospital, 3755 Chemin de la Côte Ste-Catherine, Room E-003 Montreal, QC H3T 1E2, Canada; Tel: 514-340-8222, Ext. 2948; Fax: 514-340-7502; E-mail:


It is widely known that cobalt and chromium ions can enhance the production of reactive oxygen species, known to be damaging to cells by disturbing their redox status and then generating oxidative stress. The aim of the present study was to determine if increased metal ion levels induce a state of oxidative stress in patients with metal-on-metal (MM) hip arthroplasty. Results indicated that there was no significant difference in the concentration of oxidative stress markers (total antioxidants, peroxides, and nitrated proteins) in the patients with MM bearings compared to patients without prostheses. The activity antioxidant enzymes was stable (catalase and glutathione peroxidase) or slightly decreased (superoxide dismutase and heme oxygenase-1) over time. This work is the first to determine the biological effects of metal ions released from MM hip implants with regards to mid-term systemic oxidative stress and showed that the increased levels of Co and Cr ions are not associated with significant oxidative stress damage in the plasma of patients with these implants.

Keywords: Total hip arthroplasty, metal ions, oxidative stress, antioxidant enzymes.