Dd. Dittert et al., ALUMINUM LEVELS AND STORES IN PATIENTS WITH TOTAL HIP ENDOPROSTHESES FROM TIAIV OR TIAINB ALLOYS, Archives of orthopaedic and trauma surgery, 114(3), 1995, pp. 133-136
Aluminum ranks as a potentially hazardous agent. Pathologic findings i
n different organs show that it can accumulate in brain, muscle, liver
and bone. Therefore, we investigated whether patients with cementless
total hip endoprostheses made out of titanium alloys containing alumi
num are at risk. In order to determine the complete aluminum body load
ing in patients who have had their hip replacement for a long period o
f time (mean 58 months), we mobilized possible stores of aluminum with
desferoxamine (DFO). Electrothermal atomic absorption spectroscopy wa
s used to quantify the level of aluminum in serum and urine before and
after DFO treatment. A serum aluminum value of 10 mu g/l or less is i
nternationally accepted as safe. The average serum aluminum level in t
his study was 14.2 mu g/l, which is slightly above the limit, but clea
rly below those levels which can lead to disease (> 50 mu g/l). No rel
evant storage of aluminum was found. This latter finding is more impor
tant since chronically elevated aluminum levels lead to cellular depos
its, which affect the cellular biochemistry. The values before and aft
er DFO mobilization did not differ substantially, indicating that alum
inum in alloys for biomaterials can be regarded as safe as far as the
risk of aluminum release in vivo is concerned. Histologic studies of b
one from the bone-metal interface also showed no deposits of local alu
minum release.