cobalt chrome
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Author(s):  
Kevin Deere ◽  
Gulraj S. Matharu ◽  
Yoav Ben-Shlomo ◽  
J. Mark Wilkinson ◽  
Ashley W. Blom ◽  
...  

Aims A recent report from France suggested an association between the use of cobalt-chrome femoral heads in total hip arthroplasties (THAs) and an increased risk of dilated cardiomyopathy and heart failure. Cobalt-chrome is a commonly used material in orthopaedic implants. If the reported association is causal, the consequences would be significant given the millions of joint replacements and other orthopaedic procedures in which cobalt-chrome is used annually. We examined whether cobalt-chrome-containing THAs were associated with an increased risk of all-cause mortality, heart outcomes, cancer, and neurodegenerative disorders in a large national database. Methods Data from the National Joint Registry was linked to NHS English hospital inpatient episodes for 374,359 primary THAs with up to 14.5 years follow-up. We excluded any patients with bilateral THAs, knee replacements, indications other than osteoarthritis, aged under 55 years, and diagnosis of one or more outcome of interest before THA. Implants were grouped as either containing cobalt-chrome or not containing cobalt-chrome. The association between implant construct and the risk of all-cause mortality and incident heart failure, cancer, and neurodegenerative disorders was examined. Results There were 158,677 individuals (42.4%) with an implant containing cobalt-chrome. There were 47,963 deaths, 27,332 heart outcomes, 35,720 cancers, and 22,025 neurodegenerative disorders. There was no evidence of an association that patients with cobalt-chrome implants had higher rates of any of the outcomes. Conclusion Cobalt-chrome-containing THAs did not have an increased risk of all-cause mortality, or clinically meaningful heart outcomes, cancer or neurodegenerative disorders into the second decade post-implantation. Our findings will help reassure clinicians and the increasing number of patients receiving primary THA worldwide that the use of cobalt-chrome containing implants is not associated with significant adverse systemic effects.


2021 ◽  
Author(s):  
Tulica Alexandru-Constantin ◽  
Druga Corneliu-Nicolae ◽  
Serban Ionel

2021 ◽  
pp. 103847
Author(s):  
Christopher Herpel ◽  
Antonia Springer ◽  
Galmunkh Puschkin ◽  
Lukas Zimmermann ◽  
Thomas Stober ◽  
...  

Prosthesis ◽  
2021 ◽  
Vol 3 (3) ◽  
pp. 245-260
Author(s):  
Willi Andrei Uriciuc ◽  
Adina Bianca Boșca ◽  
Anida Maria Babtan ◽  
Claudia Nicoleta Feurden ◽  
Anca Ionel ◽  
...  

In oral rehabilitation, the treatment of partial edentulism (PEd) is performed by removable partial dentures (RPD) or assembled prosthetic works (APW) composed of several components, fixed to the prosthetic field (Pa) and a removable one (Pb), in order to facilitate the daily hygiene but also the damping of the occlusal forces applied in mastication. Cobalt-Chromium alloys are materials used to manufacture modern prosthetic assembles. In order for this study to be relevant, it was necessary to standardize the design of the framework (Pa) in terms of shape and volume so that the experiment could be reproducible for the five Co-Cr alloys: 0-A (Co-Cr-Mo), 5-A and 10-A (Co-Cr-Mo-W), 15-A and 16.4-A (Co-Cr-W-Fe) and for the three fabrication methods of dental assembled prosthetic frameworks: refractory duplicate method (RD) resulting removable framework (Pb), direct construction method (DC) resulting removable framework (Pb-) and casting over metal method (CoM) resulting removable framework (Pb+). The time allocated to the adaptation process (AP), mechanical processing and sandblasting, in order to assemble the two components was between 43–70 min, even though the assembly between the Pa-framework and the complementary framework (Pb+) was not necessary, CoM-method hs been provide the elimination of AP step. By applying the arithmetic simple rule of three, the percentages for each of the three methods used were calculated, the values of the difference were obtained. The CoM method improves the joining precision between the components of the removable assembly of prosthetic frameworks by 91.7% compared to the RD method and by 80.62% compared to the DC method. According to the efficiency of the methods used in the precision of joining between frameworks components, their order is: casting over metal, direct construction and refractory duplicate method.


Dental Update ◽  
2021 ◽  
Vol 48 (8) ◽  
pp. 699-705
Author(s):  
David Gray ◽  
Olivia Barraclough ◽  
Zaid Ali ◽  
Brian Nattress

Innovations in the fabrication of removable partial dentures depend not only on the development of new materials, but also on the availability of manufacturing techniques that can be applied to a dental environment. Many of these new materials have limited clinical evaluations, hence it can be difficult for the general dental practitioner to confidently determine which materials to use. The introduction of any new material into clinical practice often requires practitioners to go through a learning curve to make the most of the material and employ it most appropriately. This article provides an update on the materials available for removable partial dentures and discusses the advantages and disadvantages to enable the GDP to make an evidence-based decision. CPD/Clinical Relevance: It is important that clinicians are aware of the alternative materials to conventional acrylic and cobalt chrome.


2021 ◽  
Vol 103-B (7 Supple B) ◽  
pp. 73-77
Author(s):  
Charles Murray Lawrie ◽  
Robert L. Barrack ◽  
Ryan M. Nunley

Aims Dual mobility (DM) implants have been shown to reduce the dislocation rate after total hip arthroplasty (THA), but there remain concerns about the use of cobalt chrome liners inserted into titanium shells. The aim of this study was to assess the clinical outcomes, metal ion levels, and periprosthetic femoral bone mineral density (BMD) at mid-term follow-up in young, active patients receiving a modular DM THA. Methods This was a prospective study involving patients aged < 65 years, with a BMI of < 35 kg/m2, and University of California, Los Angeles activity score of > 6 who underwent primary THA with a modular cobalt chrome acetabular liner, highly cross-linked polyethylene mobile bearing, and a cementless titanium femoral stem. Patient-reported outcome measures, whole blood metal ion levels (μg/l), and periprosthetic femoral BMD were measured at baseline and at one, two, and five years postoperatively. The results two years postoperatively for this cohort have been previously reported. Results A total of 43 patients were enrolled. At minimum follow-up of five years, 23 (53.4%) returned for clinical and radiological review, 25 (58.1%) had metal ion analysis performed, 19 (44.2%) underwent dual energy x-ray absorptiometry scans, and 25 (58%) completed a pain-drawing questionnaire. The mean modified Harris Hip Scores improved significantly from 54.8 (SD 19) preoperatively to 93.08 (SD 10.5) five years postoperatively (p < 0.001). One patient was revised for aseptic acetabular loosening. The mean cobalt levels increased from 0.065 μg/l (SD 0.03) to 0.08 (SD 0.05) and the mean titanium levels increased from 0.35 (SD 0.13) to 0.78 (SD 0.29). The femoral BMD ratio decreased in Gruen Zone 1 (91.9%) at five years postoperatively compared with the baseline scores at six weeks potoperatively. The femoral BMD ratio was maintained in Gruen zones 2 to 7. Conclusion The use of a modular DM component and a cementless, tapered femoral stem shows excellent mid-term survivorship with minimal concerns for corrosion and metal ion release in a cohort of young, active patients undergoing primary THA. Cite this article: Bone Joint J 2021;103-B(7 Supple B):73–77.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jashanpreet Singh ◽  
Jatinder Pal Singh

Purpose This study aims to deal with development and performance analysis of high-velocity oxy-fuel (HVOF) thermally sprayed Mo2C-based WC-CoCr (tungsten carbine cobalt chrome) (Co-10% and Cr-4%) cermet coating deposited on the pump impeller steel 316 L. Design/methodology/approach In this work, a study was carried out by modifying the conventional WC-CoCr powder with a small addition of molybdenum carbide (Mo2C). Reinforcement was done by 1–4 wt.% addition of Mo2C feedstocks in WC-CoCr powder by using a jar ball mill process. The design of experiment was implemented for optimization of the percentage of Mo2C feedstock. L16 (4 × 4) orthogonal array was used to design the experiments for erosion output for the input parameters namely velocity, particle size, concentration and Mo2C proportion. Findings Results show that the Mo2C-based WC-CoCr coating provides better microhardness as compared to conventional WC-CoCr coating. The present study also reveals that the deposition of conventional WC-CoCr coating has improved the wear resistance of SS 316 L by 9.98%. However, the slurry erosion performance of conventional WC-CoCr coating was improved as 69.6% by the addition of 3% Mo2C. Practical implications WC-CoCr coatings are universally used for protecting the equipment and machinery from abrasion, erosion and corrosion. So, the 3% Mo2C-based WC-CoCr can be useful in power plants and various industries like mining, chemical, automobile, cementing and food processing industries. Originality/value A new HVOF coating has been developed by the addition of Mo2C feedstock in WC-CoCr powder (Co 10% and Cr 4%) and the percentage of Mo2C feedstock was optimized to improve the tribological behavior of WC-CoCr coating.


Author(s):  
Julio Tobar‐Reyes ◽  
Luis Andueza‐Castro ◽  
Antonio Jiménez‐Silva ◽  
Roger Bustamante‐Plaza ◽  
Juan Carvajal‐Herrera

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