ArticleArthroplasty today2026
Systemic Cobalt Toxicity Secondary to Tibial Component Malpositioning in Bilateral Primary Total Knee Arthroplasties.
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.
What it found
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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.
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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.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
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.
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