title: Severe metallosis due to abnormal abrasion of the femoral head in a dual bearing hip prosthesis. A case report.
abstract: The authors report on a patient with a case of severe metallosis due to an abnormal abrasion of the femoral head. A primary arthroplasty was performed using a dual bearing hip prosthesis with acetabular bone grafting by ceramic screws. At the time of the revision surgery the synovia was black, and an analysis using a scanning electron microscope and scanning electron microscope-electron probe micro-analyzer revealed numerous small particles of small alumina ceramic on the inner surface of the bearing insert of high-density polyethylene. These particles, which came from the broken ceramic screws due to proximal migration of the prosthesis, scraped the femoral head away. A line and area analysis of the black synovia revealed that the synovia contained metal particles of a cobalt-chromium alloy as well as a cobalt ion. The patient's serum showed elevated concentrations of cobalt, chromium, and molybdenum that dramatically reduced 2 months after the revision surgery.
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Matsuda
authors.forename: T
authors.initials: T
authors.lastname: Yamamuro
authors.forename: R
authors.initials: R
authors.lastname: Kasai
authors.forename: Y
authors.initials: Y
authors.lastname: Matsusue
authors.forename: H
authors.initials: H
authors.lastname: Okumura
mesh_terms: D000328:Adult; D005260:Female; D017276:Friction; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007592:Joint Diseases / Q000209:etiology / Q000473:pathology; D016876:Metal Ceramic Alloys / Q000009:adverse effects*; D011859:Radiography; D012086:Reoperation; D013314:Stress, Mechanical
chemical_list: D016876:Metal Ceramic Alloys