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Enrolling by invitationNCT03359109Updated Nov 4, 2025

Metallosis on Tissues and Serum Metal Levels in Children

An observational study in Orthopedic Disorder and Retained Metal Implant, sponsored by Mayo Clinic. Enrolling by invitation at 2 sites in United States. Open to participants aged 4 Years to 18 Years. Per ClinicalTrials.gov, last updated 2025-11-04.

Sponsored by Mayo Clinic · Observational

Study type
Observational
Model
Case-control
Time perspective
Prospective
Enrollment
50
Ages
4 Years to 18 Years
Sex
All
01

Study summary

Slightly elevated blood metal levels have been found in adults undergoing hip and knee replacement. It is unknown whether pediatric patients with metal implant(plates/screws/rods) have elevated blood metal levels. This may have an impact on practice if children have high blood metal levels with routine orthopedic implants. If researchers find elevated metal levels, they may recommend patients to have the plates removed or may switch to a different type of metal. Further work on this topic is needed.

Read the detailed description

Metal implants are routinely placed in children for treatment of fracture or deformity. Long-term effects of indwelling metal implants are not well-understood. Data from this study will provide guidances as to whether some metals are safer for children (stainless vs. titanium alloys). In addition, we will document the presence of serum ion concentration for children with metal implants in place and whether this resolves after implant removal. Tissues adjacent to implants will be evaluated for signs of metallosis and wear debris. Presence of metallosis will be correlated with serum ion concentration. In vivo studies will provide data on whether metal exposure to bone cells and fibroblasts affects their inflammatory cascade and function. Based on these findings, surgeons can better counsel patients whether routine implant removal is advisable or whether stainless steel implants are safer for long-term retention compared to titanium implants. Further, novel drug targets for treatment and prevention of metallosis will be developed. This project will foster collaboration and future partnerships between the Sanford Health and Mayo Clinic research teams

02

Conditions studied

  • Orthopedic Disorder
  • Retained Metal Implant
03

Who can participate

Ages eligible
4 Years to 18 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

Pediatric patients undergoing orthopedic surgery to remove or place metal implants.

Inclusion criteria

  • Ages 4 years - 18 years
  • Stainless steel, titanium or titanium-alloy based implants, scheduled for surgery
  • De novo surgery where titanium implant placement

Exclusion criteria

Exclusion Criteria:

  • Concomitant infection
04

Study design

Observational model
Case-control
Time perspective
Prospective
Enrollment
50 participants (estimated)
Patient registry
No
Biospecimen retention
Samples with dna

Groups and cohorts

  • Stainless Steel Devices

    10 patients with stainless steel devices implanted

  • Titanium or Titanium-alloy Based Devices

    30 patients with titanium or titanium-alloy implanted devices

  • De Novo Titanium Implant

    10 patients undergoing de novo titanium implant placement who have had no previous orthopedic procedures

05

What researchers measure

Primary outcomes

  1. Mechanistic responses of bone repair cells upon Ti exposure

    To address how deregulated bone repair provokes adverse reactions, the investigators will monitor gene regulatory effects in cell culture models of titanium exposure by either silencing or activating key biological pathways

    Time frame: 3-6 months

Secondary outcomes

  1. Evaluate serum levels of metal ions

    To evaluate systemic effects of metal ions on children, the investigators will determine whether metal ion levels are elevated in participants with retained implants by intraoperatively blood draw and at first postoperatively visit. Conversely, participants undergoing implant placement will also have ion levels taken intraoperatively and then at latest follow-up visit to see if implants cause in increase in serum metal levels

    Time frame: 3-6 months

06

Study locations

2 sites
  • Mayo Clinic
    Rochester, Minnesota 55905, United States
  • Sanford Health
    Sioux Falls, South Dakota 57117, United States
07

References and documents

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03359109
Lead sponsor
Mayo Clinic
Responsible party
A. Noelle Larson, MD (Associate Professor of Orthopedics, Mayo Clinic) — Principal investigator
First posted
Dec 2, 2017
Start date
Dec 1, 2017
Primary completion
Sep 2026 (estimated)
Completion
Sep 2026 (estimated)
Last update
Nov 4, 2025

Study contacts

A.Noelle Larson, MD
principal investigator · Mayo Clinic
View the source record on ClinicalTrials.gov ↗

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