Significance of clinical reports

A similar extensive review of the relationship between metallic implants and cancer in dogs was performed by Li et al [57]. This case controlled study of 1857 dogs from 22 veterinary medical centers failed to reveal significant association between stainless steel fracture fixation devices and the development of bone and soft tissue sarcomas. 

In summary, careful examination of the scientific and clinical literature suggests that implant materials commonly used for fixation and joint reconstruction are not entirely inert. Accumulation of particulate debris is to some extent going to occur in all patients who have large prosthetic 

McLaughlin, J.K. et al (1995) Cancer risk after hip replacement with metal implants A population based study. J. National Can. Inst. 87, 28-33. 

An extensive review of risk of cancer in 39 154 total hip replacement patients who appeared in the Swedish National Cancer Registry between 1965 and 1983. A review of 60 cancer-specific sites showed an overall, not clinically significant increase of 3% in incidence, slight increases noted for kidney cancer, prostate cancer (in men) and melanoma accompanied by a continuous decline in gastric cancer for both sexes. This would appear to be the definitive review of the risk for developing cancers after total hip replacement arthroplasty. 

and Brand, I. (1980) Risk assessment of carcinogenesis at implantation sites. Plastic Reconst. Surg. 66, 591-595. 

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