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Omaima I Abdel Hamid,1 Mohamed E Attia,2 Jon M Hirshon,3,4 Mohamed El-Shinawi,5,6 Moustafa El-Hussaini,7 Maged El-Setouhy7,8 1Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt; 2Orthopedics Departments, Faculty of Medicine, Zagazig University, Zagazig, Egypt; 3Department of Emergency Medicine, University of Maryland, School of Medicine, Baltimore, MD, USA; 4Department of Epidemiology and Public Health, University of Maryland, School of Medicine, Baltimore, MD, USA; 5Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 6Galala University, Galala City, Suez, Egypt; 7Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 8Department of Family and Community Medicine, Faculty of Medince, Jazan University, Jazan, Kingdom of Saudi ArabiaCorrespondence: Omaima I Abdel Hamid, Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt, Tel +201001664310, Email dr_omaima2006@yahoo.comIntroduction: Hip arthroplasty (HA) using implantable metal components is among the commonest orthopedic interventions. However, it can be followed by several complications following corrosion and the release of metal ions. Several studies proved that damaged genomic DNA may contribute to the pathophysiology of mental disorders.Aim: The current work aims to evaluate the psychiatric disorders in metal on polyethylene hip arthroplasty (MOP-HA) patients and its correlation to cobalt/chromium (Co/Cr) levels and genotoxicity.Methods: The work was a longitudinal follow-up study including 34 adults with unilateral primary MOP-HA meeting the inclusion and exclusion criteria. Preoperatively, 6, 12-months-postoperatively, patients were examined for cognitive impairment using mini-mental-state-examination (MMSE), depression using major-depressive-inventory (MDI), and blood samples were collected for estimation of Co/Cr, detection of genotoxicity by single-cell-gel-electrophoresis (comet assay) and serum 8-hydroxy-2ââdeoxyguanosine (8-OHdG).Results: Cognitive impairment was reported in 18.5% and 14.8% at 6-months, and 12-months postoperative, respectively. Depressive disorder was recorded in 22.2% at 6-months and 14.8% at 12-months postoperative. The marginal homogeneity tests proved a non-significant difference. There was a non-significant difference in preoperative, 6-months, 12-months postoperative MMSE, and MDI scores. There were significantly increased Co/Cr levels at 6-months postoperative. The levels decreased at 12-months postoperative, however, still significantly higher than preoperative values. There was a significant increase in serum 8-OHdG and the levels were positively correlated to cobalt levels at both 6 and 12-months-postoperative. There was a non-significant difference among preoperative, 6-months, and 12-months postoperative comet assay measurements.Conclusion: From previous findings, we can conclude that will-functioning MOP hip arthroplasty can induce increased ion levels and positively correlated increase in biochemical markers of genotoxicity (8-OHdG).Keywords: metal on polyethylene hip arthroplasty, cobalt, chromium, major depressive inventory, mini-mental state examination, genotoxicity |
