title: Late instability of bilateral metal on metal hip resurfacings due to progressive local tissue effects.
abstract: Reports have emerged of local debris consisting of metal particles, with the development of pseudotumours, pelvic masses, lymphocytic perivascular infiltration of tissue around the implant and a neo-capsule tissue reaction in metal on metal (MoM) hip arthroplasty. Steeply-inclined acetabular components a large abduction angle of more than 55 degrees along with a combination of small size component are likely to give rise to higher levels of metal ions. This report describes a case of localised tissue destruction of abductor muscle probably due to the metal debris causing late onset subluxation/dislocation of a hip resurfacing. Late instability of hip resurfacing should raise concerns relating to possible local tissue reaction and muscle damage, and early revision may be recommended.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Hinchingbrooke Hospital, Huntingdon, UK. vijayortho@gmail.com
authors.forename: Vijay V
authors.initials: VV
authors.lastname: Killampalli
authors.forename: Alexander D
authors.initials: AD
authors.lastname: Reading
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000295:instrumentation*; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000209:etiology*; D008670:Metals / Q000009:adverse effects*; D008875:Middle Aged; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation
chemical_list: D008670:Metals