Abductor dysfunction and related sciatic nerve palsy, a new complication of metal-on-metal arthroplasty.
The optimal bearing for use in young patients with hip arthritis remains elusive. Current options include metal-on-cross-linked polyethylene, ceramic-on-cross-linked polyethylene, ceramic on ceramic, and metal on metal. Each of these bearing couples has advantages and disadvantages. Metal-on-metal designs allow the use of large heads that decrease impingement and improve stability. This fact has made this bearing an attractive option for surgeons and patients alike. This case report will illustrate a severe adverse reaction to metal debris with necrosis of soft tissues and subsequent damage to the sciatic nerve.
Ortho Carolina Hip and Knee Center, Charlotte, NC 28207, USA.
Walter B
WB
Beaver
Thomas K
TK
Fehring
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D001915:Braces; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008670:Metals / Q000009:adverse effects*; D018482:Muscle, Skeletal / Q000503:physiopathology*; D009989:Orthotic Devices; D011859:Radiography; D012086:Reoperation; D020426:Sciatic Neuropathy / Q000209:etiology*; D016896:Treatment Outcome
D008670:Metals