Catastrophic failure of a metal-on-metal total hip arthroplasty secondary to metal inlay dissociation.
Metal-on-metal bearing surfaces in total hip arthroplasty have been recently shown to have acceptable survivorship properties (J Bone Joint Surg Am. 2006;88:1183; J Bone Joint Surg Am. 2006;88:1173), and they have certain advantages and disadvantages when compared to conventional metal-on-polyethylene bearing surfaces. Like traditional metal-on-polyethylene bearings, these metal-on-metal implants may also suffer from catastrophic failure. This case report represents an unusual situation in a 57-year-old man in which dissociation of a metal inlay in a metal-on-metal total hip arthroplasty resulted in articulation of the inferior aspect of the inlay with the femoral neck, leading to femoral neck notching, extensive periprosthetic soft tissue metallosis, osteolysis, and subsequent prosthetic catastrophic failure.
Alaia
Michael J
MJ
Department of Orthopaedic Surgery, NYU-Hospital For Joint Diseases, 1715 Avenue T, Brooklyn, NY 11229, USA.
Dayan
Alan J
AJ
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods; D005272:Femur Neck / Q000293:injuries; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007284:Inlays / Q000009:adverse effects*; D008297:Male; D008670:Metals / Q000009:adverse effects*; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D010014:Osteolysis / Q000209:etiology; D011474:Prosthesis Design; D011475:Prosthesis Failure / Q000209:etiology*; D011859:Radiography; D012086:Reoperation
D008670:Metals