A painful metal-on-metal total hip arthroplasty: a diagnostic dilemma.
Infection, loosening, osteolysis, or other causes can lead to the development of pain about a previously well-functioning total hip arthroplasty. An inflammatory reaction unique to metal on metal arthroplasty can lead to a painful total hip. A synovial biopsy is needed to make this specific diagnosis, and included in the differential diagnosis is infection. The workup of infection includes obtaining a C-reactive protein and erythrocyte sedimentation rate. Elevations of both the C-reactive protein and erythrocyte sedimentation rate are felt to indicate possible infection. This case report describes both of these findings and the treatment rendered in a painful subluxing metal-on-metal total hip arthroplasty presenting with ongoing pain and a large effusion.
Blumenfeld
Thomas J
TJ
University of California at Davis, Sutter General Hospital, Sacramento, California 95816, USA.
Bargar
William L
WL
Campbell
Pat A
PA
D018771:Arthralgia / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D001706:Biopsy; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D006967:Hypersensitivity / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D008670:Metals / Q000009:adverse effects*; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000175:diagnosis; D013583:Synovial Membrane / Q000473:pathology
D008670:Metals; D002097:C-Reactive Protein