Cobalt toxicity after McKee hip arthroplasty.
The significance of cobalt as a cause of symptoms after McKee hip arthroplasty is discussed. Seven patients are described in whom such arthroplasties. became unsatisfactory after periods varying from nine months to four years. Six of these patients were cobalt-positive but nickel- and chrome-negative on patch testing. Macroscopic and histological necrosis of bone, muscle and joint capsule around the prostheses was found in five patients whose hips were explored. The symptoms were progressive pain, a feeling of instability, and in two cases spontaneous dislocation. Radiological features included acetabular fracture, bone resorption, loosening and dislocation of the prosthesis. Increased cobalt concentrations (determined by atomic absorption spectrophotometry) in the urine of four patients and in a variety of tissues in one patient are presented. Patch testing is recommended in the investigation of patients with troublesome McKee hip arthroplasties
D000368:Aged; D001178:Arthroplasty; D001862:Bone Resorption; D002858:Chromium Alloys; D003035:Cobalt / Q000009:adverse effects* / Q000652:urine; D005260:Female; D006617:Hip Dislocation / Q000209:etiology; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D008982:Molybdenum; D011859:Radiography; D012882:Skin Tests; D013054:Spectrophotometry, Atomic; D013997:Time Factors
D002858:Chromium Alloys; D003035:Cobalt; D008982:Molybdenum