Severe cobalt intoxication due to prosthesis wear in repeated total hip arthroplasty.
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. The cobalt concentration in blood exceeded a never before observed level. After replacement of the scraped femoral head, the cobalt concentration decreased considerably, and most of the symptoms disappeared.
Department of Maritime Medicine, University of Hamburg, Hamburg State Department for Social Affairs, Family, Health and Consumer Protection, Hamburg, Germany.
Marcus
M
Oldenburg
Ralf
R
Wegner
Xaver
X
Baur
D000058:Accidental Falls; D019644:Arthroplasty, Replacement, Hip; D003035:Cobalt / Q000506:poisoning*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011041:Poisoning / Q000209:etiology / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation
D003035:Cobalt