Acta Chir Orthop Traumatol Cech. 2020; 87(6):447-451 | DOI: 10.55095/achot2020/069

Metal Debris with Cobalt Intoxication and Heart Damage as a THA ComplicationCase report

J. HACH1, M. KUBÁNEK2, D. PELCLOVÁ3, K. LACH4, P. FULÍN5,*
1 Ortopedicko-traumatologické oddělení nemocnice Mělník
2 Klinika kardiologie, Institut klinické a experimentální medicíny, Praha
3 Klinika pracovního lékařství 1. lékařské fakulty Univerzity Karlovy a Všeobecné fakultní nemocnice, Praha
4 Centrum hygienických laboratoří, Zdravotní ústav, Ostrava
5 I. ortopedická klinika 1. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice v Motole, Praha

Total hip replacement is currently a standard orthopaedic procedure. A number of complications caused by wear of the articulating parts of the endoprosthesis were described in the past. In recent years, there have been reports of systemic manifestations of metal components wear, leading to the development of chronic metal poisoning and organ damage. Our case report documents two cases of heart damage, resulting in heart failure with the need for heart transplantation, caused by metal poisoning originating from a failed THA.

Published: December 1, 2020  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
HACH J, KUBÁNEK M, PELCLOVÁ D, LACH K, FULÍN P. Metal Debris with Cobalt Intoxication and Heart Damage as a THA Complication. Acta Chir Orthop Traumatol Cech. 2020;87(6):447-451. doi: 10.55095/achot2020/069. PubMed PMID: 33408011.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. AOANJRR. Annual report 2015 - hip and knee arthroplasty. Australian Orthopaedic Association National Joint Replacement Registry. https://aoanjrr.sahmri.com/annual-reports-2015.
    2. Endo M, Tipper JL, Barton DC, Stone MH, Ingham E, Fisher J. Comparison of wear, wear debris and functional biological activity of moderately crosslinked and non-crosslinked polyethylenes in hip prostheses. Proceedings of the Institution of Mechanical Engineers Part H. J Eng Med. 2002;216(H2):111-122. Go to original source... Go to PubMed...
    3. Keegan GM, Learmonth ID, Case CP. A systematic comparison of the actual, potential, and theoretical health effects of cobalt and chromium exposures from industry and surgical implants. Crit Rev Toxicol. 2008;38:645-674. Go to original source... Go to PubMed...
    4. Langton DJ, Jameson SS, Joyce TJ, Hallab NJ, Natu S, Nargol AVF. Early failure of metal-on-metal bearings in hip resurfacing and large-diameter total hip replacement a consequence of excess wear. J Bone Joint Surg Br. 2010;92:38-46. Go to original source... Go to PubMed...
    5. Linna A, Oksa P, Groundstroem K, Halkosaari M, Palmroos P, Huikko S, Uitti J. Exposure to cobalt in the production of cobalt and cobalt compounds and its effect on the heart. Occup Environ Med. 2004;61:877-885. Go to original source... Go to PubMed...
    6. Matthews JB, Besong AA, Green TR, Stone MH, Wroblewski BM, Fisher J, Ingham E. Evaluation of the response of primary human peripheral blood mononuclear phagocytes to challenge with in vitro generated clinically relevant UHMWPE particles of known size and dose. J Biomed Mater Res. 2000;52:296-307. Go to original source...
    7. Matziolis G, Perka C, Diech A. Massive metallosis after revision of fractured ceramic head onto a metal head. Arch Orthop Trauma Surg. 2003;123:48-50. Go to original source... Go to PubMed...
    8. NJREWNI (2015) National Joint Registry for England, Wales and Northern Ireland. 11th Annual Report 2014. http://www.njrreports.org.uk/Portals/0/PDFdownloads/NJR 11th Annual Report 2014.pdf
    9. NRKN (2019) Národní registr kloubních náhrad. Ministerstvo zdravotnictví České republiky, Praha, 2019.
    10. Oldenburg M, Wegner R, Baur X. Severe cobalt intoxication due to prosthesis wear in repeated total hip arthroplasty. J Arthroplasty. 2009;24:825.e15-20. Go to original source... Go to PubMed...
    11. Paustenbach DJ, Galbraith DA, Finley BL. Interpreting cobalt blood concentrations in hip implant patients. Clin Toxicol (Phila) 2014;52:98-112. Go to original source... Go to PubMed...
    12. Pelclova D, Sklensky M, Janicek P, Lach K. Severe cobalt intoxication following hip replacement revision: Clinical features and outcome. Clin Toxicol. 2012;50:262-265. Go to original source... Go to PubMed...
    13. SCENIHR (2015) Scientific Committee on Emerging Newly Identified Health Risks. Opinion on the safety of metal-on-metal joint replacements with a particular focus on hip implants. SCENIHR, 7th plenary, 24-25 September 2014. https://ec.europa.eu/health/scientific_committees/emerging/docs/scenihr_o_042.pdf
    14. Seghizzi,P.,D'Adda,F.et al.Cobaltmyocardiopathy.Acritical review of literature. Sci. Total. Environ. 1994;150:105-109. Go to original source... Go to PubMed...
    15. Steens W, Loehr JF, von Foerster G, Katzer A. [Chronic cobalt poisoning in endoprosthetic replacement] . Orthopade. 2006;35:860-864. Go to original source... Go to PubMed...
    16. Watters TS, Cardona DM, Menon KS, Vinson EN, Bolognesi MP, Dodd LG. Aseptic lymphocyte-dominated vasculitis-associated lesion: a clinicopathologic review of an underrecognized cause of prosthetic failure. Am J Clin Pathol. 2010;134:886-893. Go to original source... Go to PubMed...

    Return to the content