Evidence map›Paper›PMID 41799747›Full record

ArticleArthroplasty today2026

Systemic Cobalt Toxicity Secondary to Tibial Component Malpositioning in Bilateral Primary Total Knee Arthroplasties.

Nikhil Vallabhaneni, Kayla Gates, Joshua P Rainey, Jeremy M Gililland, Michael J Archibeck, Lucas A Anderson

Abstract readCase Reports
In one paragraph

Article in Arthroplasty today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Nikhil VallabhaneniDepartment of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA.
Kayla GatesDepartment of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA.
Joshua P RaineyDepartment of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA.
Jeremy M GilillandDepartment of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA.
Michael J ArchibeckDepartment of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA.
Lucas A AndersonDepartment of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Metallosis and systemic metal toxicity are uncommon complications in modern total joint arthroplasty, typically linked to metal-on-metal hip articulations. We present a case of systemic cobalt toxicity following bilateral total knee arthroplasties (TKAs), where excessive posterior tibial slope caused flexion gap instability and polyethylene wear with subsequent metallic debris release. This patient developed cognitive impairment, neuropathy, and cardiac symptoms nearly a decade after surgery, with the highest serum cobalt and chromium levels reported in literature for primary TKAs. At revision, polyethylene and baseplate wear with metallic debris and bone loss were present. Surgeons should remain vigilant for metallosis and systemic toxicity in painful or unstable TKAs with polyethylene wear from component malalignment or instability. Further studies are needed to define surveillance strategies and management guidelines.

Indexed as

Component malalignmentCorrosionInstabilityMetallosisPosterior tibial slopeSystemic metal toxicity

Identifiers

PMID41799747
PMCPMC12966873

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.