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Cobalt intoxication arthroplasty

Rinne M Peters, Pax Willemse, Paul C Rijk, Mels Hoogendoorn, Wierd P Zijlstra
This case illustrates the potential for systemic cobalt toxicity in non-metal-on-metal bearings and its potentially devastating consequences. We present a 71-year-old male with grinding sensations in his right hip following ceramic-on-ceramic total hip arthroplasty (THA). After diagnosing a fractured ceramic liner, the hip prosthesis was revised into a metal-on-polyethylene bearing. At one year postoperatively, X-rays and MARS-MRI showed a fixed reversed hybrid THA, with periarticular densities, flattening of the femoral head component, and a pattern of periarticular metal wear debris and pseudotumor formation...
2017: Case Reports in Orthopedics
Chul-Ho Kim, Young Hyun Choi, Mi Yeon Jeong, Jae Suk Chang, Pil Whan Yoon
In 1960s, toxic heart failure due to cobalt poisoning was firstly reported from Canadian industrial worker. Following development of bearing materials in hip arthroplasties, using cobalt-chrome alloy in bearing surface, there were rarely reported of systemic affect toxic cobaltism include toxic heart failure due to articulation wear in Western countries. It could be happened more easily by third body wear from ceramic particle especially revision total hip replacement (THR) surgery using cobalt-chrome alloy following ceramic articulation breakage which index surgery performed by ceramic on ceramic bearing...
December 2016: Hip & Pelvis
Jaroslaw Czekaj, Matthieu Ehlinger, Michel Rahme, Francois Bonnomet
No abstract text is available yet for this article.
May 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
S M Bradberry, J M Wilkinson, R E Ferner
INTRODUCTION: One in eight of all total hip replacements requires revision within 10 years, 60% because of wear-related complications. The bearing surfaces may be made of cobalt/chromium, stainless steel, ceramic, or polyethylene. Friction between bearing surfaces and corrosion of non-moving parts can result in increased local and systemic metal concentrations. OBJECTIVES: To identify and systematically review published reports of systemic toxicity attributed to metal released from hip implants and to propose criteria for the assessment of these patients...
September 2014: Clinical Toxicology
Kirsten Dahms, Yulia Sharkova, Peter Heitland, Sabine Pankuweit, Juergen R Schaefer
No abstract text is available yet for this article.
February 8, 2014: Lancet
(no author information available yet)
No abstract text is available yet for this article.
January 2013: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Pavel Janícek, Tomáš Tomáš, Luboš Klepác, Daniela Pelclová, Martin Sklenský
No abstract text is available yet for this article.
October 31, 2012: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Marieke A Dijkman, Irma de Vries, Henneke Mulder-Spijkerboer, Jan Meulenbelt
Since 2011, cobalt and chromium blood levels are measured in patients with a metal-on-metal hip implant (MoM prosthesis). In this article we discuss the health risks that are related to chronically elevated blood cobalt concentrations induced by abnormal wear and corrosion of the MoM prosthesis. Only a few patients who have systemic symptoms of poisoning, besides local symptoms around the failing MoM prosthesis, have been described in the literature. Toxic blood cobalt concentrations may be accompanied by hypothyroidism, polyneuropathy, impairment of cranial nerves II and VIII and cardiomyopathy...
2012: Nederlands Tijdschrift Voor Geneeskunde
Daniela Pelclova, Martin Sklensky, Pavel Janicek, Karel Lach
CONTEXT: Cobalt intoxication has become more frequent due to the wide use of metal hip implants. CASE DETAILS: A 56-year-old male patient underwent total hip prosthesis, with a ceramics-on-ceramics implant. Almost 3 years later, it was replaced by metal implant containing cobalt, chromium, and titanium. He developed weight loss, heart, thyroid, and neurological toxicity, with severe hearing loss. He was treated with 2,3-dimercaptopropane-1-sulfonate (DMPS), and cobalt excretion increased...
April 2012: Clinical Toxicology
Tokuhei Ikeda, Kazuya Takahashi, Tamon Kabata, Daigo Sakagoshi, Katsuro Tomita, Masahito Yamada
Although metal intoxication after arthroplasty causes various symptoms, polyneuropathy has never been the focus of clinical investigation. We report the case of a 56-year-old woman with metal neuropathy. She had metallosis after hip arthroplasty with a cobalt-chromium alloy prosthesis. She developed progressive sensory disturbance, hearing loss, and hypothyroidism. Sural nerve biopsy indicated axonopathy. After exchange arthroplasty, blood levels of cobalt and chromium decreased, and her symptoms improved. Cobalt or chromium can cause axonopathy...
July 2010: Muscle & Nerve
Marcus Oldenburg, Ralf Wegner, Xaver Baur
Our study describes a 55-year-old man with a total hip prosthesis (ceramic femoral head and polyethylene [PE] inlay). After a fall, the ceramic head broke into several pieces, and a subsequent revision surgery with metal femoral head and PE inlay was performed. Three months later, the so far healthy patient complained of multiorgan symptoms. The subsequent clinical examinations revealed hypothyroidism, peripheral neuropathy, and cardiomyopathy for the first time. In a second revision surgery, a massive deterioration of the metal femoral head by overlooked particles of the broken ceramic head was found...
August 2009: Journal of Arthroplasty
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