{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:32:50Z","timestamp":1789173170641,"version":"build-2803163510"},"reference-count":70,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc Toxicol"],"published-print":{"date-parts":[[2026,2]]},"DOI":"10.1007\/s12012-026-10099-7","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T03:47:15Z","timestamp":1770004035000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Cobalt-Induced Cardiomyopathy: Mitochondrial Dysfunction, Oxidative Stress, and Reversible Cardiac Toxicity: A Systematic Review"],"prefix":"10.1007","volume":"26","author":[{"given":"Darshan","family":"Hullon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5767-0722","authenticated-orcid":false,"given":"Abiya","family":"Ahad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sultan Mujib","family":"Dabiry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lovepreet","family":"Mahindra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"issue":"15","key":"10099_CR1","first-page":"926","volume":"97","author":"Y Morin","year":"1967","unstructured":"Morin, Y., & Daniel, P. (1967). Quebec beer-drinkers\u2019 cardiomyopathy: Etiological considerations. Canadian Medical Association Journal, 97(15), 926\u2013928.","journal-title":"Canadian Medical Association Journal"},{"issue":"4","key":"10099_CR2","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/0002-9343(72)90136-2","volume":"53","author":"CS Alexander","year":"1972","unstructured":"Alexander, C. S. (1972). Cobalt-beer cardiomyopathy. A clinical and pathologic study of twenty-eight cases. American Journal of Medicine, 53(4), 395\u2013417. https:\/\/doi.org\/10.1016\/0002-9343(72)90136-2","journal-title":"American Journal of Medicine"},{"issue":"6","key":"10099_CR3","first-page":"620","volume":"34","author":"JQ Jarvis","year":"1992","unstructured":"Jarvis, J. Q., Hammond, E., Meier, R., & Robinson, C. (1992). Cobalt cardiomyopathy. A report of two cases from mineral assay laboratories and a review of the literature. Journal of Occupational Medicine, 34(6), 620\u2013626.","journal-title":"Journal of Occupational Medicine"},{"issue":"3","key":"10099_CR4","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1007\/s40883-021-00222-1","volume":"7","author":"CC Ude","year":"2021","unstructured":"Ude, C. C., Esdaille, C. J., Ogueri, K. S., Ho-Man, K., Laurencin, S. J., Nair, L. S., & Laurencin, C. T. (2021). The mechanism of metallosis after total hip arthroplasty. Regenerative Engineering and Translational Medicine, 7(3), 247\u2013261. https:\/\/doi.org\/10.1007\/s40883-021-00222-1","journal-title":"Regenerative Engineering and Translational Medicine"},{"issue":"8","key":"10099_CR5","doi-asserted-by":"publisher","first-page":"837","DOI":"10.3109\/15563650.2014.944977","volume":"52","author":"SM Bradberry","year":"2014","unstructured":"Bradberry, S. M., Wilkinson, J. M., & Ferner, R. E. (2014). Systemic toxicity related to metal hip prostheses. Clinical Toxicology (Philadelphia), 52(8), 837\u2013847. https:\/\/doi.org\/10.3109\/15563650.2014.944977","journal-title":"Clinical Toxicology (Philadelphia)"},{"issue":"1","key":"10099_CR6","doi-asserted-by":"publisher","DOI":"10.1186\/s12989-020-00396-6","volume":"18","author":"M Savi","year":"2021","unstructured":"Savi, M., Bocchi, L., Cacciani, F., Vilella, R., Buschini, A., Perotti, A., Galati, S., Montalbano, S., Pinelli, S., Frati, C., Corradini, E., Quaini, F., Ruotolo, R., Stilli, D., & Zaniboni, M. (2021). Cobalt oxide nanoparticles induce oxidative stress and alter electromechanical function in rat ventricular myocytes. Particle and Fibre Toxicology, 18(1), Article 1. https:\/\/doi.org\/10.1186\/s12989-020-00396-6","journal-title":"Particle and Fibre Toxicology"},{"key":"10099_CR7","doi-asserted-by":"publisher","DOI":"10.1016\/j.etap.2020.103488","volume":"80","author":"AA Oyagbemi","year":"2020","unstructured":"Oyagbemi, A. A., Akinrinde, A. S., Adebiyi, O. E., Jarikre, T. A., Omobowale, T. O., Ola-Davies, O. E., Saba, A. B., Emikpe, B. O., & Adedapo, A. A. (2020). Luteolin supplementation ameliorates cobalt-induced oxidative stress and inflammation by suppressing NF-\u03baB\/Kim-1 signaling in the heart and kidney of rats. Environmental Toxicology and Pharmacology, 80, Article 103488. https:\/\/doi.org\/10.1016\/j.etap.2020.103488","journal-title":"Environmental Toxicology and Pharmacology"},{"issue":"1","key":"10099_CR8","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1002\/mus.21638","volume":"42","author":"T Ikeda","year":"2010","unstructured":"Ikeda, T., Takahashi, K., Kabata, T., Sakagoshi, D., Tomita, K., & Yamada, M. (2010). Polyneuropathy caused by cobalt-chromium metallosis after total hip replacement. Muscle & Nerve, 42(1), 140\u2013143. https:\/\/doi.org\/10.1002\/mus.21638","journal-title":"Muscle & Nerve"},{"issue":"6","key":"10099_CR9","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1080\/009841096161122","volume":"48","author":"EH Jeffery","year":"1996","unstructured":"Jeffery, E. H., Abreo, K., Burgess, E., Cannata, J., & Greger, J. L. (1996). Systemic aluminum toxicity: Effects on bone, hematopoietic tissue, and kidney. Journal of Toxicology and Environmental Health, 48(6), 649\u2013665. https:\/\/doi.org\/10.1080\/009841096161122","journal-title":"Journal of Toxicology and Environmental Health"},{"issue":"4","key":"10099_CR10","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1002\/jat.2729","volume":"32","author":"I Polyzois","year":"2012","unstructured":"Polyzois, I., Nikolopoulos, D., Michos, I., Patsouris, E., & Theocharis, S. (2012). Local and systemic toxicity of nanoscale debris particles in total hip arthroplasty. Journal of Applied Toxicology, 32(4), 255\u2013269. https:\/\/doi.org\/10.1002\/jat.2729","journal-title":"Journal of Applied Toxicology"},{"issue":"3","key":"10099_CR11","doi-asserted-by":"publisher","first-page":"951","DOI":"10.1016\/j.nano.2018.01.001","volume":"14","author":"DR Bijukumar","year":"2018","unstructured":"Bijukumar, D. R., Segu, A., Souza, J. C. M., Li, X., Barba, M., Mercuri, L. G., Jacobs, J. J., & Mathew, M. T. (2018). Systemic and local toxicity of metal debris released from hip prostheses: A review of experimental approaches. Nanomedicine, 14(3), 951\u2013963. https:\/\/doi.org\/10.1016\/j.nano.2018.01.001","journal-title":"Nanomedicine"},{"issue":"13","key":"10099_CR12","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1016\/S0142-9612(99)00235-5","volume":"21","author":"N Hallab","year":"2000","unstructured":"Hallab, N., Jacobs, J. J., & Black, J. (2000). Hypersensitivity to metallic biomaterials: A review of leukocyte migration inhibition assays. Biomaterials, 21(13), 1301\u20131314. https:\/\/doi.org\/10.1016\/S0142-9612(99)00235-5","journal-title":"Biomaterials"},{"issue":"2","key":"10099_CR13","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1002\/ehf2.14695","volume":"11","author":"M Casian","year":"2024","unstructured":"Casian, M., Bica, R., Ionescu, V., Predescu, V., \u021aincu, R., & Jurcu\u021b, R. (2024). Too young for an acquired cardiomyopathy? Cobalt metallosis as a cardiac amyloidosis mimicker. ESC Heart Failure, 11(2), 1236\u20131241. https:\/\/doi.org\/10.1002\/ehf2.14695","journal-title":"ESC Heart Failure"},{"issue":"1","key":"10099_CR14","doi-asserted-by":"publisher","DOI":"10.1186\/s12968-016-0248-z","volume":"18","author":"A Abdel-Gadir","year":"2016","unstructured":"Abdel-Gadir, A., Berber, R., Porter, J. B., Quinn, P. D., Suri, D., Kellman, P., Hart, A. J., Moon, J. C., Manisty, C., & Skinner, J. A. (2016). Detection of metallic cobalt and chromium liver deposition following failed hip replacement using T2* and R2 magnetic resonance. Journal of Cardiovascular Magnetic Resonance, 18(1), Article 29. https:\/\/doi.org\/10.1186\/s12968-016-0248-z","journal-title":"Journal of Cardiovascular Magnetic Resonance"},{"issue":"7","key":"10099_CR15","doi-asserted-by":"publisher","first-page":"e159","DOI":"10.1093\/ajhp\/zxad312","volume":"81","author":"CA Floyd","year":"2024","unstructured":"Floyd, C. A., Carr, J. R., Brock, L., & Orvin, D. L. (2024). Enteral N-acetylcysteine to reduce serum cobalt concentrations secondary to prosthetic knee-associated metallosis: A case report. American Journal of Health-System Pharmacy, 81(7), e159\u2013e165. https:\/\/doi.org\/10.1093\/ajhp\/zxad312","journal-title":"American Journal of Health-System Pharmacy"},{"issue":"3","key":"10099_CR16","first-page":"E132","volume":"45","author":"BA Mosier","year":"2016","unstructured":"Mosier, B. A., Maynard, L., Sotereanos, N. G., & Sewecke, J. J. (2016). Progressive cardiomyopathy in a patient with elevated cobalt ion levels and bilateral metal-on-metal hip arthroplasties. American Journal of Orthopedics (Belle Mead, NJ), 45(3), E132\u2013E135.","journal-title":"American Journal of Orthopedics (Belle Mead, NJ)"},{"issue":"6","key":"10099_CR17","doi-asserted-by":"publisher","first-page":"447","DOI":"10.55095\/achot2020\/069","volume":"87","author":"J Hach","year":"2020","unstructured":"Hach, J., Kub\u00e1nek, M., Pelclov\u00e1, D., Lack, K., & Fulin, P. (2020). Metal debris with Cobalt intoxication and heart damage as a THA complication. Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca, 87(6), 447.","journal-title":"Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca"},{"key":"10099_CR18","doi-asserted-by":"publisher","DOI":"10.5301\/HIP.2013.10755","author":"D Pelclov\u00e1","year":"2013","unstructured":"Pelclov\u00e1, D. (2013). Retraction: \u201cChronic intoxication with Cobalt following revision total hip arthroplasty.\u201d Hip International. https:\/\/doi.org\/10.5301\/HIP.2013.10755","journal-title":"Hip International"},{"key":"10099_CR19","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/3373363","volume":"2022","author":"P Szedlak","year":"2022","unstructured":"Szedlak, P., Virdi, A., Cacciottolo, P., Shepherd, S., Pettit, S., & Falter, F. (2022). Cardiac transplantation following cobalt cardiomyopathy from bilateral metal-on-metal hip replacements. Case Reports in Anesthesiology, 2022, Article 3373363. https:\/\/doi.org\/10.1155\/2022\/3373363","journal-title":"Case Reports in Anesthesiology"},{"issue":"3","key":"10099_CR20","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.120.011561","volume":"14","author":"M Dagan","year":"2021","unstructured":"Dagan, M., Russ, M. K., & Hare, J. L. (2021). Case of mistaken identity: Cobalt cardiomyopathy versus amyloidosis on cardiac MRI. Circulation. Cardiovascular Imaging, 14(3), Article e011561. https:\/\/doi.org\/10.1161\/CIRCIMAGING.120.011561","journal-title":"Circulation. Cardiovascular Imaging"},{"issue":"1","key":"10099_CR21","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1007\/s12012-018-9480-0","volume":"19","author":"HI Choi","year":"2019","unstructured":"Choi, H. I., Hong, J. A., Kim, M. S., Lee, S. E., Jung, S. H., Yoon, P. W., Song, J. S., & Kim, J. J. (2019). Severe cardiomyopathy due to arthroprosthetic cobaltism: Report of two cases with different outcomes. Cardiovascular Toxicology, 19(1), 82\u201389. https:\/\/doi.org\/10.1007\/s12012-018-9480-0","journal-title":"Cardiovascular Toxicology"},{"issue":"1529","key":"10099_CR22","first-page":"103","volume":"134","author":"G Giacon","year":"2021","unstructured":"Giacon, G., & Boon, K. (2021). Cobalt toxicity: A preventable and treatable cause for possibly life-threatening cardiomyopathy. New Zealand Medical Journal, 134(1529), 103\u2013108.","journal-title":"New Zealand Medical Journal"},{"issue":"4","key":"10099_CR23","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytab057","volume":"5","author":"C Castrillo Bustamante","year":"2021","unstructured":"Castrillo Bustamante, C., Canteli \u00c1lvarez, \u00c1., Burgos Palacios, V., Sarralde Aguayo, J. A., Serrano Lozano, D., Arana Achaga, X., Nu\u00f1ez Rodr\u00edguez, \u00c1., & Cobo Belaustegui, M. (2021). A case report of cobalt cardiomyopathy leading to electric storm and cardiogenic shock: The importance of the orthopaedic background in patients with heart failure of unknown aetiology. European Heart Journal Case Reports, 5(4), Article ytab057. https:\/\/doi.org\/10.1093\/ehjcr\/ytab057","journal-title":"European Heart Journal Case Reports"},{"issue":"10","key":"10099_CR24","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1016\/j.jcmg.2014.12.016","volume":"8","author":"HY Samar","year":"2015","unstructured":"Samar, H. Y., Doyle, M., Williams, R. B., Yamrozik, J. A., Bunker, M., Biederman, R. W. W., & Shah, M. B. (2015). Novel use of cardiac magnetic resonance imaging for the diagnosis of Cobalt cardiomyopathy. Jacc. Cardiovascular Imaging, 8(10), 1231\u20131232. https:\/\/doi.org\/10.1016\/j.jcmg.2014.12.016","journal-title":"Jacc. Cardiovascular Imaging"},{"issue":"4","key":"10099_CR25","first-page":"379","volume":"7","author":"D Gautam","year":"2019","unstructured":"Gautam, D., Pande, A., & Malhotra, R. (2019). Fatal Cobalt cardiomyopathy following revision total hip arthroplasty: A brief report with review of literature. Archives of Bone and Joint Surgery, 7(4), 379\u2013383.","journal-title":"Archives of Bone and Joint Surgery"},{"issue":"11","key":"10099_CR26","doi-asserted-by":"publisher","first-page":"1392","DOI":"10.1016\/j.cjco.2021.06.010","volume":"3","author":"M Singh","year":"2021","unstructured":"Singh, M., Krishnan, M., Ghazzal, A., Halushka, M., Tozzi, J. E., Bunning, R. D., Rodrigo, M. E., Najjar, S. S., Molina, E. J., & Sheikh, F. H. (2021). From hip to heart: A comprehensive evaluation of an infiltrative cardiomyopathy. CJC Open, 3(11), 1392\u20131395. https:\/\/doi.org\/10.1016\/j.cjco.2021.06.010","journal-title":"CJC Open"},{"issue":"2","key":"10099_CR27","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/j.artd.2017.01.005","volume":"3","author":"S Moniz","year":"2017","unstructured":"Moniz, S., Hodgkinson, S., & Yates, P. (2017). Cardiac transplant due to metal toxicity associated with hip arthroplasty. Arthroplasty Today, 3(2), 117\u2013120. https:\/\/doi.org\/10.1016\/j.artd.2017.01.005","journal-title":"Arthroplasty Today"},{"issue":"4","key":"10099_CR28","doi-asserted-by":"publisher","first-page":"NP1","DOI":"10.1177\/1120700019834793","volume":"29","author":"MI Sanz P\u00e9rez","year":"2019","unstructured":"Sanz P\u00e9rez, M. I., Rico Villoras, A. M., Moreno Velasco, A., Bartolom\u00e9 Garc\u00eda, S., & Campo Loarte, J. (2019). Heart transplant secondary to cobalt toxicity after hip arthroplasty revision. Hip International, 29(4), NP1\u2013NP5. https:\/\/doi.org\/10.1177\/1120700019834793","journal-title":"Hip International"},{"issue":"9","key":"10099_CR29","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1080\/15563650.2016.1214274","volume":"54","author":"KA Fox","year":"2016","unstructured":"Fox, K. A., Phillips, T. M., Yanta, J. H., & Abesamis, M. G. (2016). Fatal cobalt toxicity after total hip arthroplasty revision for fractured ceramic components. Clinical Toxicology (Philadelphia), 54(9), 874\u2013877. https:\/\/doi.org\/10.1080\/15563650.2016.1214274","journal-title":"Clinical Toxicology (Philadelphia)"},{"issue":"3","key":"10099_CR30","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1016\/j.artd.2019.04.010","volume":"5","author":"M Umar","year":"2019","unstructured":"Umar, M., Jahangir, N., Faisal Khan, M., Saeed, Z., Sultan, F., & Sultan, A. (2019). Cobalt cardiomyopathy in hip arthroplasty. Arthroplast Today, 5(3), 371\u2013375. https:\/\/doi.org\/10.1016\/j.artd.2019.04.010","journal-title":"Arthroplast Today"},{"issue":"12","key":"10099_CR31","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.116.003604","volume":"9","author":"M Packer","year":"2016","unstructured":"Packer, M. (2016). Cobalt cardiomyopathy: A critical reappraisal in light of a recent resurgence. Circulation. Heart Failure, 9(12), Article e003604. https:\/\/doi.org\/10.1161\/CIRCHEARTFAILURE.116.003604","journal-title":"Circulation. Heart Failure"},{"issue":"1","key":"10099_CR32","doi-asserted-by":"publisher","first-page":"18","DOI":"10.2106\/JBJS.C.00949","volume":"87","author":"AP Davies","year":"2005","unstructured":"Davies, A. P., Willert, H. G., Campbell, P. A., Learmonth, I. D., & Case, C. P. (2005). An unusual lymphocytic perivascular infiltration in tissues around contemporary metal-on-metal joint replacements. Journal of Bone and Joint Surgery - American Volume, 87(1), 18\u201327. https:\/\/doi.org\/10.2106\/JBJS.C.00949","journal-title":"Journal of Bone and Joint Surgery - American Volume"},{"key":"10099_CR33","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/j.jor.2021.01.008","volume":"23","author":"A Dutta","year":"2021","unstructured":"Dutta, A., Nutt, J., Slater, G., & Ahmed, S. (2021). Trunnionosis leading to modular femoral head dissociation: A review. J Orthop, 23, 199\u2013202. https:\/\/doi.org\/10.1016\/j.jor.2021.01.008","journal-title":"J Orthop"},{"issue":"5","key":"10099_CR34","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1177\/0960327111414280","volume":"31","author":"S Catalani","year":"2012","unstructured":"Catalani, S., Rizzetti, M. C., Padovani, A., & Apostoli, P. (2012). Neurotoxicity of cobalt. Human and Experimental Toxicology, 31(5), 421\u2013437. https:\/\/doi.org\/10.1177\/0960327111414280","journal-title":"Human and Experimental Toxicology"},{"issue":"5","key":"10099_CR35","first-page":"441","volume":"16","author":"S de Moraes","year":"1967","unstructured":"de Moraes, S., & Mariano, M. (1967). Biochemical aspects of cobalt intoxication: Cobalt ion action on oxygen uptake. Med Pharmacol Exp Int J Exp Med, 16(5), 441\u2013447.","journal-title":"Med Pharmacol Exp Int J Exp Med"},{"issue":"1","key":"10099_CR36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1081\/DCT-100100098","volume":"23","author":"EF Madden","year":"2000","unstructured":"Madden, E. F., & Fowler, B. A. (2000). Mechanisms of nephrotoxicity from metal combinations: A review. Drug and Chemical Toxicology, 23(1), 1\u201312. https:\/\/doi.org\/10.1081\/DCT-100100098","journal-title":"Drug and Chemical Toxicology"},{"issue":"5","key":"10099_CR37","first-page":"813","volume":"21","author":"RA Yokel","year":"2000","unstructured":"Yokel, R. A. (2000). The toxicology of aluminum in the brain: A review. Neurotoxicology, 21(5), 813\u2013828.","journal-title":"Neurotoxicology"},{"issue":"8 Suppl","key":"10099_CR38","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.arth.2012.03.029","volume":"27","author":"YM Kwon","year":"2012","unstructured":"Kwon, Y. M., Jacobs, J. J., MacDonald, S. J., Potter, H. G., Fehring, T. K., & Lombardi, A. V. (2012). Evidence-based understanding of management perils for metal-on-metal hip arthroplasty patients. The Journal of Arthroplasty, 27(8 Suppl), 20\u201325. https:\/\/doi.org\/10.1016\/j.arth.2012.03.029","journal-title":"The Journal of Arthroplasty"},{"issue":"19","key":"10099_CR39","doi-asserted-by":"publisher","first-page":"2946","DOI":"10.1016\/j.biomaterials.2007.02.034","volume":"28","author":"I Papageorgiou","year":"2007","unstructured":"Papageorgiou, I., Brown, C., Schins, R., Singh, S., Newson, R., Davis, S., Fisher, J., Ingham, E., & Case, C. P. (2007). The effect of nano- and micron-sized particles of cobalt-chromium alloy on human fibroblasts in vitro. Biomaterials, 28(19), 2946\u20132958. https:\/\/doi.org\/10.1016\/j.biomaterials.2007.02.034","journal-title":"Biomaterials"},{"issue":"27","key":"10099_CR40","doi-asserted-by":"publisher","first-page":"4590","DOI":"10.1016\/j.biomaterials.2009.05.008","volume":"30","author":"JX Wang","year":"2009","unstructured":"Wang, J. X., Fan, Y. B., Gao, Y., Hu, Q. H., & Wang, T. C. (2009). TiO\u2082 nanoparticles translocation and potential toxicological effect in rats after intraarticular injection. Biomaterials, 30(27), 4590\u20134600. https:\/\/doi.org\/10.1016\/j.biomaterials.2009.05.008","journal-title":"Biomaterials"},{"key":"10099_CR41","doi-asserted-by":"publisher","DOI":"10.1186\/s12989-015-0082-8","volume":"12","author":"S Lu","year":"2015","unstructured":"Lu, S., Zhang, W., Zhang, R., Liu, P., Wang, Q., Shang, Y., Wu, M., Donaldson, K., & Wang, Q. (2015). Comparison of cellular toxicity caused by ambient ultrafine particles and engineered metal oxide nanoparticles. Particle and Fibre Toxicology, 12, Article 5. https:\/\/doi.org\/10.1186\/s12989-015-0082-8","journal-title":"Particle and Fibre Toxicology"},{"issue":"4","key":"10099_CR42","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1002\/jbm.a.31789","volume":"86A","author":"M Caicedo","year":"2008","unstructured":"Caicedo, M., Jacobs, J. J., Reddy, A., & Hallab, N. J. (2008). Analysis of metal ion-induced DNA damage, apoptosis, and necrosis in human (Jurkat) T-cells demonstrates Ni\u00b2\u207a and V\u00b3\u207a are more toxic than other metals: Al\u00b3\u207a, Be\u00b2\u207a, Co\u00b2\u207a, Cr\u00b3\u207a, Cu\u00b2\u207a, Fe\u00b3\u207a, Mo\u2075\u207a, Nb\u2075\u207a, Zr\u00b2\u207a. Journal of Biomedical Materials Research. Part A, 86A(4), 905\u2013913. https:\/\/doi.org\/10.1002\/jbm.a.31789","journal-title":"Journal of Biomedical Materials Research. Part A"},{"issue":"3","key":"10099_CR43","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1111\/j.1365-2249.2006.03226.x","volume":"146","author":"JT Minang","year":"2006","unstructured":"Minang, J. T., Arestr\u00f6m, I., Troye-Blomberg, M., Lundeberg, L., & Ahlborg, N. (2006). Nickel, cobalt, chromium, palladium and gold induce a mixed Th1- and Th2-type cytokine response in vitro in subjects with contact allergy to the respective metals. Clinical and Experimental Immunology, 146(3), 417\u2013426. https:\/\/doi.org\/10.1111\/j.1365-2249.2006.03226.x","journal-title":"Clinical and Experimental Immunology"},{"issue":"33","key":"10099_CR44","doi-asserted-by":"publisher","first-page":"11613","DOI":"10.1073\/pnas.0801763105","volume":"105","author":"SE Gratton","year":"2008","unstructured":"Gratton, S. E., Ropp, P. A., Pohlhaus, P. D., Luft, J. C., Madden, V. J., Napier, M. E., & DeSimone, J. M. (2008). The effect of particle design on cellular internalization pathways. Proceedings of the National Academy of Sciences of the United States of America, 105(33), 11613\u201311618. https:\/\/doi.org\/10.1073\/pnas.0801763105","journal-title":"Proceedings of the National Academy of Sciences of the United States of America"},{"issue":"1\u20133","key":"10099_CR45","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/0048-9697(94)90129-5","volume":"150","author":"B Nemery","year":"1994","unstructured":"Nemery, B., Lewis, C. P., & Demedts, M. (1994). Cobalt and possible oxidant-mediated toxicity. Science of the Total Environment, 150(1\u20133), 57\u201364. https:\/\/doi.org\/10.1016\/0048-9697(94)90129-5","journal-title":"Science of the Total Environment"},{"issue":"2","key":"10099_CR46","volume":"2","author":"P Tran","year":"2022","unstructured":"Tran, P., Banerjee, R., Joshi, M., & Banerjee, P. (2022). Heart failure heralded by hip pain: A case of cobalt cardiomyopathy after hip arthroplasty. Open Journal of Clinical and Medical Images, 2(2), Article 1076.","journal-title":"Open Journal of Clinical and Medical Images"},{"issue":"Suppl","key":"10099_CR47","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1136\/hrt.33.suppl.171","volume":"33","author":"G Rona","year":"1971","unstructured":"Rona, G. (1971). Experimental aspects of cobalt cardiomyopathy. British Heart Journal, 33(Suppl), 171\u2013174. https:\/\/doi.org\/10.1136\/hrt.33.suppl.171","journal-title":"British Heart Journal"},{"issue":"1","key":"10099_CR48","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1302\/0301-620X.92B1.22770","volume":"92","author":"DJ Langton","year":"2010","unstructured":"Langton, D. J., Jameson, S. S., Joyce, T. J., Hallab, N. J., Natu, S., & Nargol, A. V. (2010). Early failure of metal-on-metal bearings in hip resurfacing and large-diameter total hip replacement: A consequence of excess wear. Journal of Bone and Joint Surgery. British Volume, 92(1), 38\u201346. https:\/\/doi.org\/10.1302\/0301-620X.92B1.22770","journal-title":"Journal of Bone and Joint Surgery. British Volume"},{"issue":"6","key":"10099_CR49","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1302\/0301-620X.91B6.21682","volume":"91","author":"AJ Hart","year":"2009","unstructured":"Hart, A. J., Sabah, S., Henckel, J., Lewis, A., Cobb, J., Sampson, B., Mitchell, A., & Skinner, J. A. (2009). The painful metal-on-metal hip resurfacing. Journal of Bone and Joint Surgery. British Volume, 91(6), 738\u2013744. https:\/\/doi.org\/10.1302\/0301-620X.91B6.21682","journal-title":"Journal of Bone and Joint Surgery. British Volume"},{"issue":"5852","key":"10099_CR50","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1136\/bmj.1.5852.527","volume":"1","author":"RF Coleman","year":"1973","unstructured":"Coleman, R. F., Herrington, J., & Scales, J. T. (1973). Concentration of wear products in hair, blood, and urine after total hip replacement. BMJ (Clinical Research Ed.), 1(5852), 527\u2013529. https:\/\/doi.org\/10.1136\/bmj.1.5852.527","journal-title":"BMJ (Clinical Research Ed.)"},{"issue":"4","key":"10099_CR51","doi-asserted-by":"publisher","first-page":"262","DOI":"10.3109\/15563650.2012.670244","volume":"50","author":"D Pelclova","year":"2012","unstructured":"Pelclova, D., Sklensky, M., Janicek, P., & Lach, K. (2012). Severe Cobalt intoxication following hip replacement revision: Clinical features and outcome. Clinical Toxicology (Philadelphia, Pa), 50(4), 262\u2013265. https:\/\/doi.org\/10.3109\/15563650.2012.670244","journal-title":"Clinical Toxicology (Philadelphia, Pa)"},{"issue":"Suppl 3","key":"10099_CR52","doi-asserted-by":"publisher","first-page":"142","DOI":"10.2106\/JBJS.H.00442","volume":"90","author":"J Antoniou","year":"2008","unstructured":"Antoniou, J., Zukor, D. J., Mwale, F., Minarik, W., Petit, A., & Huk, O. L. (2008). Metal ion levels in the blood of patients after hip resurfacing: A comparison between twenty-eight and thirty-six-millimeter-head metal-on-metal prostheses. The Journal of Bone and Joint Surgery. American Volume, 90(Suppl 3), 142\u2013148. https:\/\/doi.org\/10.2106\/JBJS.H.00442","journal-title":"The Journal of Bone and Joint Surgery. American Volume"},{"key":"10099_CR53","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-34177-w","volume":"13","author":"F Migliorini","year":"2023","unstructured":"Migliorini, F., Pilone, M., Bell, A., et al. (2023). Serum cobalt and chromium concentration following total hip arthroplasty: A Bayesian network meta-analysis. Scientific Reports, 13, Article 6918. https:\/\/doi.org\/10.1038\/s41598-023-34177-w","journal-title":"Scientific Reports"},{"issue":"1","key":"10099_CR54","first-page":"1","volume":"8","author":"F Billi","year":"2010","unstructured":"Billi, F., & Campbell, P. (2010). Nanotoxicology of metal wear particles in total joint arthroplasty: A review of current concepts. Journal of Applied Biomaterials & Biomechanics, 8(1), 1\u20136.","journal-title":"Journal of Applied Biomaterials & Biomechanics"},{"issue":"4","key":"10099_CR55","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1021\/nl052396o","volume":"6","author":"BD Chithrani","year":"2006","unstructured":"Chithrani, B. D., Ghazani, A. A., & Chan, W. C. (2006). Determining the size and shape dependence of gold nanoparticle uptake into mammalian cells. Nano Letters, 6(4), 662\u2013668. https:\/\/doi.org\/10.1021\/nl052396o","journal-title":"Nano Letters"},{"issue":"7","key":"10099_CR56","doi-asserted-by":"publisher","first-page":"2305","DOI":"10.1007\/s11999-015-4156-6","volume":"473","author":"O Lainiala","year":"2015","unstructured":"Lainiala, O., Reito, A., Elo, P., Pajam\u00e4ki, J., Puolakka, T., & Eskelinen, A. (2015). Revision of metal-on-metal hip prostheses results in marked reduction of blood cobalt and chromium ion concentrations. Clinical Orthopaedics and Related Research, 473(7), 2305\u201313. https:\/\/doi.org\/10.1007\/s11999-015-4156-6","journal-title":"Clinical Orthopaedics and Related Research"},{"issue":"4","key":"10099_CR57","doi-asserted-by":"publisher","first-page":"457","DOI":"10.2106\/00004623-200004000-00002","volume":"82","author":"RM Urban","year":"2000","unstructured":"Urban, R. M., Jacobs, J. J., Tomlinson, M. J., Gavrilovic, J., Black, J., & Peoc\u2019h, M. (2000). Dissemination of wear particles to the liver, spleen, and abdominal lymph nodes of patients with hip or knee replacement. Journal of Bone and Joint Surgery - American Volume, 82(4), 457\u201376. https:\/\/doi.org\/10.2106\/00004623-200004000-00002","journal-title":"Journal of Bone and Joint Surgery - American Volume"},{"issue":"3","key":"10099_CR58","doi-asserted-by":"publisher","first-page":"1575","DOI":"10.1097\/MS9.0000000000001773","volume":"86","author":"D Hullon","year":"2024","unstructured":"Hullon, D., Taherifard, E., & Al-Saraireh, T. H. (2024). The effect of the four pharmacological pillars of heart failure on haemoglobin level. Annals of Medicine and Surgery (London), 86(3), 1575\u20131583. https:\/\/doi.org\/10.1097\/MS9.0000000000001773","journal-title":"Annals of Medicine and Surgery (London)"},{"issue":"1-4","key":"10099_CR59","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/j.bbrc.2018.10.185","volume":"507","author":"L Yang","year":"2018","unstructured":"Yang, L., Wang, D., Wang, X. T., Lu, Y. P., & Zhu, L. (2018). The roles of hypoxia-inducible factor-1 and iron regulatory protein 1 in iron uptake induced by acute hypoxia. Biochemical and Biophysical Research Communications, 507(1\u20134), 128\u2013135. https:\/\/doi.org\/10.1016\/j.bbrc.2018.10.185","journal-title":"Biochemical and Biophysical Research Communications"},{"issue":"4","key":"10099_CR60","first-page":"623","volume":"74","author":"W Fried","year":"1969","unstructured":"Fried, W., & Kilbridge, T. (1969). Effect of testosterone and of Cobalt on erythropoietin production by anephric rats. Journal of Laboratory and Clinical Medicine, 74(4), 623\u2013629.","journal-title":"Journal of Laboratory and Clinical Medicine"},{"issue":"3","key":"10099_CR61","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/S0300-483X(03)00147-1","volume":"190","author":"A Katzer","year":"2003","unstructured":"Katzer, A., Hockertz, S., Buchhorn, G. H., & Loehr, J. F. (2003). In vitro toxicity and mutagenicity of CoCrMo and Ti6Al wear particles. Toxicology, 190(3), 145\u2013154. https:\/\/doi.org\/10.1016\/S0300-483X(03)00147-1","journal-title":"Toxicology"},{"key":"10099_CR62","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1016\/j.biomaterials.2015.07.034","volume":"67","author":"MJ Pearson","year":"2015","unstructured":"Pearson, M. J., Williams, R. L., Floyd, H., Bodansky, D., Grover, L. M., Davis, E. T., & Lord, J. M. (2015). The effects of cobalt-chromium-molybdenum wear debris in vitro on serum cytokine profiles and T cell repertoire. Biomaterials, 67, 232\u2013239. https:\/\/doi.org\/10.1016\/j.biomaterials.2015.07.034","journal-title":"Biomaterials"},{"issue":"Suppl 1","key":"10099_CR63","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/10937400701597766","volume":"10","author":"D Krewski","year":"2007","unstructured":"Krewski, D., Yokel, R. A., Nieboer, E., Borchelt, D., Cohen, J., Harry, J., Kacew, S., Lindsay, J., Mahfouz, A. M., & Rondeau, V. (2007). Human health risk assessment for aluminium, aluminium oxide, and aluminium hydroxide. Journal of Toxicology and Environmental Health, Part B: Critical Reviews, 10(Suppl 1), 1\u2013269. https:\/\/doi.org\/10.1080\/10937400701597766","journal-title":"Journal of Toxicology and Environmental Health, Part B: Critical Reviews"},{"issue":"5","key":"10099_CR64","doi-asserted-by":"publisher","first-page":"639.e1","DOI":"10.1016\/j.cjca.2012.10.015","volume":"29","author":"CJ Gilbert","year":"2013","unstructured":"Gilbert, C. J., Cheung, A., Butany, J., Zywiel, M. G., Syed, K., McDonald, M., Wong, F., & Overgaard, C. (2013). Hip pain and heart failure: The missing link. Canadian Journal of Cardiology, 29(5), 639.e1-639.e2. https:\/\/doi.org\/10.1016\/j.cjca.2012.10.015","journal-title":"Canadian Journal of Cardiology"},{"issue":"Suppl A","key":"10099_CR65","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1302\/0301-620X.106B3.BJJ-2023-0814.R1.","volume":"106-B","author":"MRJ Jenkinson","year":"2024","unstructured":"Jenkinson, M. R. J., Meek, D. R. M., Tate, R., Brady, A., MacMillan, S., Grant, H., & Currie, S. (2024). Cardiac function may be compromised in patients with elevated blood cobalt levels secondary to metal-on-metal hip implants. Bone & Joint Journal, 106-B(Suppl A), 51\u201358. https:\/\/doi.org\/10.1302\/0301-620X.106B3.BJJ-2023-0814.R1.","journal-title":"Bone & Joint Journal"},{"key":"10099_CR66","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1016\/j.ijcard.2018.05.047","volume":"271","author":"F Lodge","year":"2018","unstructured":"Lodge, F., Khatun, R., Lord, R., John, A., Fraser, A. G., & Yousef, Z. (2018). Prevalence of subclinical cardiac abnormalities in patients with metal-on-metal hip replacements. International Journal of Cardiology, 271, 274\u2013280. https:\/\/doi.org\/10.1016\/j.ijcard.2018.05.047","journal-title":"International Journal of Cardiology"},{"issue":"1\u20133","key":"10099_CR67","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/0048-9697(94)90135-X","volume":"150","author":"P Seghizzi","year":"1994","unstructured":"Seghizzi, P., D\u2019Adda, F., Borleri, D., Barbic, F., & Mosconi, G. (1994). Cobalt myocardiopathy: A critical review of the literature. Science of the Total Environment, 150(1\u20133), 105\u2013109. https:\/\/doi.org\/10.1016\/0048-9697(94)90135-X","journal-title":"Science of the Total Environment"},{"issue":"12","key":"10099_CR68","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.1080\/14796678.2025.2554026","volume":"21","author":"D Hullon","year":"2025","unstructured":"Hullon, D., Saraireh, T. H. A., Obaidi, G. A., Mirza, H., Fediunina, V. A., Oskouyan, Z., Al-Sudani, N., & Tawallbeh, M. A. (2025). Systematic review of cardiac ventricular dysfunction in Wilson\u2019s disease: Mechanisms, diagnostic advancements, and management strategies. Future Cardiology, 21(12), 1187\u20131199. https:\/\/doi.org\/10.1080\/14796678.2025.2554026","journal-title":"Future Cardiology"},{"issue":"3","key":"10099_CR69","doi-asserted-by":"publisher","first-page":"17","DOI":"10.57238\/jbb.2023.6960.1038","volume":"2","author":"A Ahad","year":"2023","unstructured":"Ahad, A. (2023). Direct oral anticoagulants in the treatment of acute venous thromboembolism in patients with obesity: A systematic review with meta-analysis. Journal of Biomedicine and Biochemistry, 2(3), 17\u201327. https:\/\/doi.org\/10.57238\/jbb.2023.6960.1038","journal-title":"Journal of Biomedicine and Biochemistry"},{"key":"10099_CR70","doi-asserted-by":"publisher","DOI":"10.1159\/000549272","author":"D Hullon","year":"2025","unstructured":"Hullon, D., Farhan, E., Hussain, F., Ahad, A., Akhavan, M., & Abouelsoud, M. H. (2025). Cardiac arrhythmias associated with brain tumors: A systematic review. Cardiology. https:\/\/doi.org\/10.1159\/000549272","journal-title":"Cardiology"}],"container-title":["Cardiovascular Toxicology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12012-026-10099-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12012-026-10099-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12012-026-10099-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T16:05:39Z","timestamp":1771949139000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12012-026-10099-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":70,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10099"],"URL":"https:\/\/doi.org\/10.1007\/s12012-026-10099-7","relation":{},"ISSN":["1530-7905","1559-0259"],"issn-type":[{"value":"1530-7905","type":"print"},{"value":"1559-0259","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"7 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}},{"value":"Not applicable. This study presents a conceptual framework and does not involve human or animal subjects.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"This systematic review analyzed previously published studies and did not involve human participants, human data, or human tissue.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}},{"value":"Consent for Publication is given by all authors.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}}],"article-number":"24"}}