Quantifying Titanium in Implants (written Elizabeth Hofheinz @ OTW)
According to new research published in Analytical and Bioanalytical Chemistry,researchers from Spain have developed a highly sensitive method of quantifying the levels of titanium (Ti) in the blood of patients fitted with titanium orthopedic implants. Yoana Nuevo-Ordóñez and colleagues of the Sanz-Medel research group from the University of Oviedo have established a baseline for natural levels of titanium in untreated individuals, as well as measuring levels in patients with surgical implants.
The results? Controls had very low levels of titanium in the blood, whereas titanium concentrations were significantly higher for all the patients with implants. There were also significant differences in titanium levels for different types of bone fixation devices. The more invasive implants shed more metallic debris into the blood than the external, superficial designs. The work also identified how the titanium from the implants is transported in the bloodstream and potentially distributed and accumulated.
Professor Alfredo Sanz-Medel, one of the study’s lead authors, told OTW,
At the beginning it was surprising to see that analytical techniques used for the determination of these levels of Ti in biological samples, even based on ICP-MS were not appropriate and high resolution was mandatory for such studies. Furthermore, there was little literature available on the possible Ti release from intramedullary Ti nails in particular, in spite that they are of common use for fracture fixation particularly in young people. Out of our studies here we could confirm Ti dissemination in the body from all the patients carrying the different intramedullary metallic implants (femoral, tibial, etc.) at the levels we observed previously in total hip arthroplasty. This was also very surprising since total hip replacement were expected to have the largest Ti liberation rate.
Professor Sanz-Medel added, “Right now we are continuing this research line by studying other Ti implants (spinal fusion implants) with higher and lower rate of articulation with the aim of having a complete picture of Ti dissemination from different metallic devices. We are trying to address the biological consequences of such liberation by studying first, the form in which Ti is transported in serum (as metal ion, as nanoparticles, etc.) since this will have an impact on the potential toxicity inside the cells. A key aspect will be to investigate the potential toxicity of low Ti levels but during long exposure period, in order to see if we a have a reason to be concerned or not. Finally, our DF-ICP-MS tools are most appropriated to measure and investigate Ti releases in different new materials, nanomaterials, etc. used or pending to be applied in Ti-based orthopedical implants.”
To orthopedists, Professor Sanz-Medel says,
In general, they should know that the only way of improving human beings quality of life related to prosthesis success is to conduct joint research investigations that provide different visions of the same problem. In particular, that when they say that Ti (or platinum) are ‘inert biomaterials they should maintain a reasonable doubt until practical and sound studies on such inertness are appropriately carried out and established with adequate analytical tools and collaborative studies.