Orthopedics Medical News about lymphopenia

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Circulating levels of cobalt and chromium from metal-on-metal hip replacement are associated with CD8+ T-cell lymphopenia
The Journal of Bone and Joint Surgery (British Volume), 06/03/09

Hart AJ et al. - Statistical modelling with analysis of covariance using age, gender, type of hip replacement, smoking and circulating metal ion levels, showed that circulating levels of metal ions, especially cobalt, explained the variation in absolute lymphocyte counts for almost all lymphocyte subsets.

Exclusive Author Commentary
Mr A. J. Hart, 06/03/09

Our initial paper on this subject (JBJS B 2006) reported results that were a complete surprise to us because we were expecting to find something quite different. However, it is well known that changes in blood cell numbers may reflect local inflammation, so together with our current paper, maybe our finding of a low CD8 count in patients with Metal on metal (MOM) hips is real, rather than the product of a confounder that we have not yet discovered. It is difficult to find clinical situations where many individuals are exposed to continuous doses of nanoparticles, MOM hips are one such situation. Thus, orthopaedic surgeons have inadvertently allowed a window into the world of in-human immune system responses to metallic nanoparticles. Our findings may be related to the reports of local T and B cell infiltrations surrounding MOM hips. Our other papers on the subject of MOM hips can be found at http://www1.imperial.ac.uk/medicine/about/divisions/sora/biosurg/musculo/retrieval/

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