1. Cobalt toxicity after revision total hip replacement due to fracture of a ceramic head.
- Author
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Pelayo-de Tomás JM, Novoa-Parra C, and Gómez-Barbero P
- Subjects
- Aged, Ceramics, Heavy Metal Poisoning diagnosis, Humans, Male, Arthroplasty, Replacement, Hip instrumentation, Cobalt poisoning, Heavy Metal Poisoning etiology, Hip Prosthesis adverse effects, Prosthesis Failure adverse effects
- Abstract
Symptomatic cobalt toxicity from a failed total hip replacement is a rare, but devastating complication. Potential clinical findings include cardiomyopathy, hypothyroidism, skin rash, visual and hearing impairment, polycythaemia, weakness, fatigue, cognitive impairment, and neuropathy. The case is presented of a 74year-old man in whom, after a ceramic-ceramic replacement and two episodes of prosthetic dislocation, it was decided to replace it with a polyethylene-metal total hip arthroplasty (THA). At 6months after the revision he developed symptoms of cobalt toxicity, confirmed by analytical determination (serum cobalt level=651.2μg/L). After removal of the prosthesis, the levels of chromium and cobalt in blood and urine returned to normal, with the patient currently being asymptomatic. It is recommended to use a new ceramic on ceramic bearing at revision, in order to minimise the risk of wear-related cobalt toxicity following breakage of ceramic components., (Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2017
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