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There was also evidence from one trial that patients receiving metal on metal implants have a lower quality of life (functional component) than patients receiving metal on polyethylene bearing.
Disease specific functional outcomes and general quality of life scores were no different or they favoured patients receiving metal on polyethylene rather than metal on metal in the trials.
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A similar conclusion was reached for a constructed wetland receiving metal-rich acid mine drainage in Colorado.[2] Likewise, chemical analysis of cattail tissues collected after one year of operation suggests that metabolic uptake of metals by Typha latifolia was minimal compared to the total metal loadings.
The same investigators also assessed the risk of cancer in patients receiving metal-on-metal stemmed hips, metal-on-metal resurfacings, and other bearing stemmed total hips.
A randomized trial involving 85 patients matched for age and sex and randomized to receiving metal-on-metal (n = 41) or metal-on-polyethylene total hip arthroplasty (n = 44) was conducted.
Given the large number of people who have received metal devices, that could mean thousands of patients in the United States.
DePuy, Zimmer and other companies and doctors have said that most patients who received metal hips have done well.
Enhanced metal ion concentrations have been reported widely from hair, blood and urine samples of patients who received metal hip replacements and in isolated cases when abnormally high levels have caused adverse local tissue reactions.
In one study, one out of three older patients undergoing hip surgery received metal on metal hip implants.
14 Concerns regarding the effects of metal ions have been noted after a landmark paper by MacDonald et al 36 that noted a 5.3-fold increase in erythrocyte cobalt, a 35-fold increase in urinary cobalt, and a 17-fold increase in urinary chromium concentrations in patients who received metal on metal hip replacements compared with those who received metal on polyethylene.
Surface water receives metals from natural and anthropogenic sources in natural condition.
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