Systemic Effects of Cobalt Toxicity after Revision Hip Replacement can Manifest in Intermediate to Long Term Follow-Up

Introduction Metal toxicity from metal-on-metal hip replacements is now well documented and several large series have reported local reactions. Although less common, there are reports of similar reactions from failed ceramic liners. Systemic effects documented in literature have been grouped into ca...

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Bibliographic Details
Published in:Hip international 2016-07, Vol.26 (4), p.e31-e34
Main Authors: Vasukutty, Nijil L., Minhas, Tahawwar Hasnat Ahmad
Format: Article
Language:English
Subjects:
Adult
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Hip - instrumentation
Ceramics
Cobalt - poisoning
Hip Prosthesis - adverse effects
Humans
Male
Osteonecrosis - surgery
Postoperative Complications - etiology
Prosthesis Design - adverse effects
Reoperation
Time Factors
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Summary:Introduction Metal toxicity from metal-on-metal hip replacements is now well documented and several large series have reported local reactions. Although less common, there are reports of similar reactions from failed ceramic liners. Systemic effects documented in literature have been grouped into cardiac, neuro-ocular and thyroid signs. Methods and results We report a case of a patient who had revision for fractured ceramic liner to metal on polyethylene. Third body effect of the ceramic particles led to wear through of the poly liner and the head directly articulating with metal shell. He developed cardiac and neurological features of cobalt toxicity in addition to extensive soft tissue destruction. Revision of the bearing surfaces and synovectomy led to clinical improvement and fall in metal ion levels. Conclusions We recommend 2-stage revision in such situations and close monitoring of all these patients.
ISSN:1120-7000
1724-6067
DOI:10.5301/hipint.5000386