title: Two cases of metallosis from metal-on-polyethylene total hips: an emerging problem.
abstract: This report describes 2 cases of metallosis from metal-on-polyethylene total hip replacements. Case 1 involved a Stryker rejuvenate implant, which has since been recalled. This patient had minimal symptoms, an elevated cobalt level, and loosening. The patient in case 2 had a Dupuys Pinnacle system, with symptoms of weakness, rash, and hip pain. Abnormal laboratory values include elevated sedimentation rate, C-reactive protein, creatinine, cobalt, and decreased hematocrit. Magnetic resonance imaging revealed synovial thickening and extracapsular edema. Although metallosis is a well-established complication of metal-on-metal implants, emerging data reveal that it also may be a problem in non-metal-on-metal implants such as either metal-on-polyethylene or ceramic-on-polyethylene implants, perhaps related to modular corrosion.
authors.affiliation: Georgetown University/MedStar National Rehabilitation Hospital, Washington, DC(∗).
authors.forename: Cyrus
authors.initials: C
authors.lastname: Kao
authors.affiliation: George Washington University Hospital, Washington, DC(†).
authors.forename: Raymond
authors.initials: R
authors.lastname: Scalettar
authors.affiliation: Georgetown University/MedStar National Rehabilitation Hospital, Washington, DC(‡). Electronic address: robert.d.bunning@medstar.net.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Bunning
mesh_terms: D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D003035:Cobalt / Q000097:blood* / Q000633:toxicity*; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D020959:Polyethylene; D011474:Prosthesis Design
chemical_list: D003035:Cobalt; D020959:Polyethylene